伤椎螺钉的空间位置对AO分型A型胸腰椎骨折椎体高度的影响分析  

Effect of spatial location of the screw at the injured vertebra on the vertebral height in AO type A thoracolumbar fracture

作　　者：廖旭昱[1] 马维虎[1] 刘观燚[1] 周雷杰[1] 韩金明[1] Liao Xuyu;Ma Weihu;Liu Guanyi;Zhou Leijie;Han Jinming(Department of Spine Surgery,The Sixth Hospital of Ningbo,Ningbo 315040,Zhejiang,China)

机构地区：[1]宁波市第六医院脊柱外科,315040

出　　处：《中华创伤骨科杂志》2021年第7期564-570,共7页Chinese Journal of Orthopaedic Trauma

摘　　要：目的比较伤椎螺钉的3种空间位置对A型胸腰椎骨折椎体高度的影响。方法回顾性分析2016年1月至2019年6月宁波市第六医院脊柱外科住院治疗的156例A型胸腰椎骨折患者资料。根据伤椎螺钉的空间位置分为3组:A组55例,位于椎弓根纵轴平分线和上终板之间的椎体区域;B组52例,位于椎弓根纵轴平分线和椎弓根下切迹顶点水平线之间的椎体区域;C组49例,位于椎弓根下切迹顶点水平线和下终板之间的椎体区域。比较3组患者间以及同一组患者术前、术后1周及末次随访时的椎体前缘、中间、后缘高度、Beck指数及伤椎成角。结果三组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。所有患者术后1周和末次随访时椎体前缘、中间高度、Beck指数均高于术前,伤椎成角均小于术前,差异有统计学意义(P<0.05),而上述指标术后1周和末次随访时比较差异均无统计学意义(P>0.05)。所有患者术后1周椎体后缘高度高于术前和末次随访时,差异均有统计学意义(P<0.05);而末次随访时和术前比较,差异均无统计学意义(P>0.05)。末次随访时A、B两组伤椎前缘、中间高度、Beck指数高于C组,伤椎成角小于C组,差异均有统计学意义(P<0.05);而上述指标A、B两组间比较差异均无统计学意义(P>0.05)。结论伤椎置钉平行和接近上终板,位于和椎弓根纵轴相对应的椎体的中上部分,会有利于术中椎体复位,并且有利于维持术后椎体高度和减少术后椎体高度的丢失。Objective To compare the effects of 3 spatial locations of the screw at the injured vertebra on the vertebral height in AO type A thoracolumbar fracture.Methods A retrospective analysis was performed of the 156 patients with type A thoracolumbar fracture who had been hospitalized at Department of Spine Surgery,The Sixth Hospital of Ningbo from January 2016 to June 2019.They were divided into 3 groups according to the spatial location of the screw at the injured vertebra.In group A of 55 cases,the screws were located in the vertebral body between the longitudinal axis bisector of the vertebral pedicle and the upper endplate;in group B of 52 cases,the screws were located in the vertebral body between the vertical axis bisector of the vertebral pedicle and the horizontal line of the apex of the inferior pedicle notch;in group C of 49 cases,the screws were located in the vertebral body between the horizontal line at the apex of the inferior pedicle notch and the inferior endplate.The anterior,middle and posterior heights of the injured vertebra,Beck index and angulation of the injured vertebra at preoperation,one week postoperation and the last follow-up were compared between the 3 groups and within the same group.Results There was no significant difference in preoperative general data between the 3 groups,showing comparability(P>0.05).In all the 3 groups,the anterior and middle heights of the injured vertebra and Beck indexes at one week postoperation and at the last follow-up were significantly larger than those before operation while the angulations of the injured vertebra at one week postoperation and at the last follow-up were significantly smaller than the preoperative values(all P<0.05),but there was no significant difference between one week postoperation and the last follow-up in any of the above indexes(P>0.05).In all the patients,the posterior height of the injured vertebra at one week postoperation was significantly larger than those before operation and at the last follow-up(P<0.05),but there was no such

关 键 词：胸椎 腰椎 脊柱骨折 内固定器 椎体高度 

分 类 号：R687.3[医药卫生—骨科学]