多平面Ponte截骨矫形治疗老年性胸腰椎陈旧性骨折伴后凸畸形  

作　　者：周成洪 严望军[2] 朱文浩 龙亨国 刘邦能 邵伟伟 

机构地区：[1]舟山市中医院,316000 [2]上海长征医院,200003 [3]上海中医药大学附属龙华医院,200032

出　　处：《浙江临床医学》2022年第2期223-225,共3页Zhejiang Clinical Medical Journal

基　　金：舟山市卫生科技计划项目(20I7B01)。

摘　　要：目的探讨多平面Pome截骨矫形技术治疗老年性胸腰椎陈旧性骨折伴后凸畸形的疗效。方法24例老年性胸腰椎陈旧性骨折伴后凸畸形患者均采用后路内固定联合Ponte截骨矫形技术进行手术,比较手术前后脊柱Cobb角变化、脊柱ODI评分及JOA评分,术后随访行X线及三维CT复查植骨融合情况。结果所有病例均获随访,随访26〜48(36.6±3.4)个月,术后脊柱成角畸形明显改善。手术前Cobb角为(37.14±6.42)°,ODI评分为(42.23±2.34)分,JOA评分为(7.53±0.62)分;末次随访时Cobb角为(15.34±2.12)°,ODI评分为(4.02±1.52)分,JOA评分为(24.83±0.52)分;上述三项指标比较,差异均有统计学意义(P<0.01)。术后X线及三维CT复查显示,所有植骨均Ⅰ期融合,融合时间3〜7(4.2±0.3)个月。结论多平面Pome截骨矫形技术联合后路椎弓根螺钉能够有效矫正脊柱后凸畸形,防止内固定再次失败、复位去失,且创伤性小。Objective To investigate the effect of multi-plane Ponte osteotomy and osteotomy and orthopedic technique in the treatment of senile thoracolumbar fracture with kyphosis.Methods 24 cases of senile thoracolumbar fractures with kyphosis were treated with posterior internal fixation combined with Ponte osteotomy and orthopedics.The changes of Cobb Angle,ODI score and JOA score of the spine were compared before and after the operation.X-ray and three-dimensional CT were followed up to review the bone graft fusion.Results All patients were followed up for 26~48(36.6±3.4)months,and the postoperative spinal angulation was significantly improved.Before the operation,Cobb's angle was(37.14±6.42)°,ODI score was(42.23±2.34),and JOA score was(7.53±0.62).At the last follow-up,Cobh’s angle was(15.34±2.12)°,ODI score was(4.02±1.52)and JOA score was(24.83±0.52).The differences of the above three indexes were statistically significant(P<0.01).Postoperative X-ray and three-dimensional CT reexamination showed that all bone grafts were fused at stage Ⅰ,and the fusion time was 3~7(4.2±0.3)months.Conclusion Ponte osteotomy and orthopedic technique combined with posterior pedicle screw for the treatment of senile thoracolumbar fractures with kyphosis,can effectively correct kyphosis,prevent internal fixation failure again,loss of reduction and less trauma.

关 键 词：截骨矫形 胸腰椎 陈旧骨折 后凸畸形 

分 类 号：R68[医药卫生—骨科学]