经皮椎弓根钉棒内固定术治疗胸腰椎骨折的疗效  

The efficacy of percutaneous pedicle screw-rod internal fixation for thoracolumbar fracture

作　　者：胡俊翔 林华杰 贾晋荣 HU Jun-xiang;LIN Hua-jie;JIA Jin-rong(Dept of Orthopaedics,Ningbo Traditional Chinese Medical Hospital,Ningbo,Zhejiang 315010,China)

机构地区：[1]宁波市中医院骨科,浙江宁波315010

出　　处：《临床骨科杂志》2022年第3期319-322,共4页Journal of Clinical Orthopaedics

基　　金：浙江省中医药管理局中医药计划青年项目(编号:2021ZQ082)。

摘　　要：目的探讨经皮椎弓根钉棒内固定术治疗胸腰椎骨折的疗效。方法采用经皮椎弓根钉棒内固定术治疗19例胸腰椎骨折患者。记录矢状面后凸Cobb角、伤椎前缘高度百分比以评估椎体骨折复位情况,采用疼痛VAS评分、MacNab标准评估胸腰椎功能改善情况。结果患者均获得随访,时间12~16(14.5±1.8)个月。切口均一期愈合,无感染、神经根或脊髓损伤等并发症发生。骨折均愈合,时间4~7(5.2±1.1)个月;未出现椎弓根螺钉断裂、松动现象。矢状面后凸Cobb角、伤椎前缘高度百分比、疼痛VAS评分术后6个月均明显优于术前(P<0.01)。末次随访时采用MacNab标准评估胸腰椎功能改善情况:优12例,良5例,可1例,差1例,优良率17/19。结论采用经皮椎弓根钉棒内固定术治疗胸腰椎骨折,伤椎高度可明显恢复,疼痛及腰背部功能显著改善。Objective To investigate clinical efficacy of percutaneous pedicle screw-rod internal fixation in the treatment of thoracolumbar fractures.Methods The 19 patients with thoracolumbar fractures were treated with percutaneous pedicle screw-rod fixation.The sagittal kyphotic Cobb angle and the percentage of the injured vertebral anterior edge height were used to evaluate the reduction situation of injured vertebrae.The pain VAS and MacNab criteria were used to evaluate the improvement of thoracolumbar function.Results All patients were followed up for 12~16(14.5±1.8)months.All incisions were healed in the first stage,and there were no complications such as infection,nerve root or spinal cord inury.All the fractures healed within 4~7(5.2±1.1)months,without pedicle screw-rod fracture or loosening.The sagittal kyphotic Cobb angle,the percentage of anterior edge height of the injured vertebrae,pain VAS at 6 months after surgery were significantly improved than those before surgery(P<0.01).At the last follow-up,MacNab criteria was used to evaluate the improvement of thoracolumbar function:12 cases were excellent,5cases good,1 case fair,and 1 poor,the excellent-good rate was 17/19.Conclusions In treatment of thoracolumbar fracture,percutaneous pedicle screw-rod internal fixation can effectively restore the height of the injured vertebrae,improve the pain and low back function.

关 键 词：经皮椎弓根钉棒 胸腰椎骨折 内固定术 椎体复位 

分 类 号：R683.2[医药卫生—骨科学] R687.32[医药卫生—外科学]