后路椎弓根内固定治疗胸腰椎骨折的临床效果  

Effects of posterior pedicle internal fixation on thoracolumbar vertebral fractures

作　　者：梁伟之 冯卫华 江洁 高金伟 Liang Weizhi;Feng Weihua;Jiang Jie;Gao Jinwei(Department of Orthopedics,Shanxi Provincial Armed Police Hospital,Taiyuan 030006,China)

机构地区：[1]武警山西省总队医院骨科,太原030006

出　　处：《中国实用医刊》2020年第19期41-44,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨后路椎弓根内固定治疗胸腰椎骨折的临床效果。方法抽取2017年5月至2019年4月武警山西省总队医院收治的56例胸腰椎骨折患者为研究对象,采用后路椎弓根内固定治疗。比较患者治疗前后椎体前后缘高度、矢状面Cobb角、椎体横截面积,观察患者术后神经功能恢复情况及并发症发生情况。结果 56例患者术后椎体前缘高度、椎体后缘高度高于术前,椎体横截面积大于术前,矢状面Cobb角小于术前,差异有统计学意义(P<0.05)。术后胸腰神经Frankel分级中E级占比高于术前,差异有统计学意义(P<0.05)。术后复位不良6例,螺钉断裂1例,下肢无感觉1例,脑脊液漏2例,脊神经根损伤1例,提示后路椎弓根内固定治疗存在一定损伤。结论后路椎弓根内固定治疗胸腰椎骨折,具有重建脊椎稳定性,促进脊椎自然弯曲的作用,且术后能够有效改善患者胸腰神经功能,促进感觉及运动神经改善,但手术存在一定损伤,需要采取有效的预防措施减少术后并发症影响。Objective To investigate the therapeutic effects of posterior pedicle internal fixation on thoracolumbar vertebral fractures.Methods A total of 56 patients with thoracolumbar vertebral fractures treated in Shanxi Provincial Armed Police Hospital from May 2017 to April 2019 were selected as the research objects.All patients were treated by posterior pedicle internal fixation.The preoperative and postoperative heights of the anterior and posterior edges of the vertebral body,sagittal Cobb angle,and cross-sectional area of the vertebral body were compared.The postoperative neurological function recovery and the occurrence of complications were observed.Results After operation,the height of the anterior vertebral body and the height of the posterior vertebral body were higher,the cross-sectional area of the vertebral body was larger,and the sagittal Cobb angle was smaller,compared to the preoperative indexes,and the difference was statistically significant(P<0.05).After operation,the proportion of E grade the posterior thoracolumbar nerve in Frankel classification was higher than that before the operation,and the difference was statistically significant(P<0.05).There were 6 cases poor reduction,1 case screw breakage,1 case lower extremity sensation,2 cases cerebrospinal fluid leakage,and 1 case spinal nerve root injury after treatment,suggesting that posterior pedicle internal fixation would make impact on patients in some degree.Conclusions Posterior pedicle internal fixation for thoracolumbar vertebral fractures has the effect of rebuilding spine stability and promoting the natural curvature of the spine.It can effectively improve the patient’s thoracolumbar nerve function and promote the improvement of sensory and motor nerves after surgery.However,the treatment also require effective preventive measures to reduce the impact of postoperative complications.

关 键 词：后路椎弓根 内固定治疗 胸腰椎骨折 胸腰神经 椎体横截面积 复位不良 

分 类 号：R687.3[医药卫生—骨科学]