两种方式骨水泥强化椎弓根螺钉对老年骨质疏松性胸腰椎骨折治疗效果及神经功能的影响  

Effect of two methods of cement-reinforced pedicle screw on the treatment and neurological function of senile osteoporotic thoracolumbar fractures

作　　者：李波 马航展 黄海珊[2] LI Bo;MA Hang-zhan;HUANG Hai-shan(Department of Orthopaedics,Shiqiao Hospital of Panyu District in Guangzhou City,Guangdong Province,Guangzhou 511400,China;Department of Orthopaedics,Guangzhou Panyu District Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou 511400,China)

机构地区：[1]广州市番禺区市桥医院骨科,广东广州511400 [2]广州市番禺区中医院骨科,广东广州511400

出　　处：《中国当代医药》2019年第19期119-121,共3页China Modern Medicine

基　　金：广东省广州市番禺区科技项目(2017-Z04-60)

摘　　要：目的探讨两种方式骨水泥强化椎弓根螺钉对老年骨质疏松性胸腰椎骨折的治疗效果及神经功能的影响。方法选取2016年5月~2018年10月广州市番禺区市桥医院手术的胸腰椎骨折患者92例,参考奇偶数随机分成A组(经钉道注入骨水泥)、B组(经钉尾注入骨水泥),每组各46例。比较两组围术期指标、螺钉固定效果、神经功能改善和并发症发生情况。结果两组手术时间等围术期指标比较,差异无统计学意义(P>0.05);两组术后椎体前缘高度减少值、后凸Cobb角和Oswestry功能障碍指数(ODI)均低于术前,且B组各指标均低于A组(P<0.05);B组并发症总发生率低于A组(P<0.05);术后B组神经功能损伤评定(Frankle)分级优于A组(P<0.05)。结论经钉尾注入骨水泥强化椎弓根螺钉对老年骨质疏松性胸腰椎骨折具有较好的固定效果,且在术后神经功能改善方面作用更明显,且并发症发生率较低。Objective To investigate the effect of two methods of cement-reinforced pedicle screw on the treatment and neurological function of senile osteoporotic thoracolumbar fractures. Methods A total of 92 patients with thoracolumbar fractures who underwent surgery in Shiqiao Hospital, Panyu District, Guangzhou City from May 2016 to October 2018 were selected and divided into group A (bone cement injected through the nail channel) and group B (bone cement injected through nail tail) according to the odd-even method, 46 cases in each group. Perioperative index, screw fixation, neurological improvement and complications were compared between the two groups. Results There were no significant differences in perioperative indexes between the two groups (P>0.05). The height reduction of the vertebral body, kyphosis and Oswestry dysfunction index (ODI) after operation were lower than those before operation, and the indexes of group B were lower than those of group A (P<0.05). The total incidence of complication in group B was lower than that of group A (P<0.05). The nerve function damage (Frankle ) grade in group B was better than that of group A (P<0.05). Conclusion Intensive pedicle screw fixation with bone cement has a good fixation effect on senile osteoporotic thoracolumbar fractures, and it has more obvious effect on neurological improvement, and fewer complications.

关 键 词：胸腰椎骨折 椎弓根螺钉 骨水泥 固定效果 神经功能 

分 类 号：R683.2[医药卫生—骨科学]