改良撑开复位技术治疗Denis B型胸腰椎骨折的临床疗效  

The clinical efficacy of improved distraction reduction technique in treatment of Denis B-type thoracolumbar fractures

作　　者：廖国权 石林新 吴成如 孙国荣 史凤之 高升 俞军卫 陈然 顾庆陟 LIAO Guo-quan;SHI Lin-xin;WU Cheng-ru;SUN Guo-rong;SHI Feng-zhi;GAO Sheng;YU Jun-wei;CHEN Ran;GU Qing-zhi(Department of Orthopedics,No.901 Hospital of the Joint Logistics Support Force of the People’s Liberation Army,Anhui,230031,China)

机构地区：[1]解放军联勤保障部队第901医院骨二科,安徽合肥230031

出　　处：《颈腰痛杂志》2023年第3期398-401,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨改良撑开复位技术治疗Denis B型胸腰椎骨折的临床疗效。方法回顾性分析2018年7月~2021年6月本科采用改良撑开复位技术治疗的Denis B型胸腰椎骨折患者35例(改良组),并与同期采用传统撑开复位技术治疗的30例患者(传统组)进行对比。统计两组患者的手术时间、手术出血量,术前、术后即刻、3个月、6个月和12个月时的疗效指标、影像学指标及并发症发生情况。结果所有患者顺利完成手术并获得12~36(23.0±5.4)个月随访。两组手术时间、手术出血量差异无统计学意义(P>0.05)。与术前相比,两组患者术后伤椎Cobb角和伤椎前缘高度均有所改善(P<0.05),且传统组术后即刻的伤椎Cobb角和伤椎前缘高度明显优于改良组(P<0.05),但两组术后3~12个月的差异无统计学意义(P>0.05)。改良组患者术后3~12个月的VAS评分、ODI指数均显著低于传统组,差异有统计学意义(P<0.05)。改良组骨折愈合时间明显短于传统组(P<0.05)。改良组无断钉、断棒及内固定松动现象;传统组1例患者术后4个月时发生2枚螺钉在钉头连接处断裂。结论Denis B型胸腰椎骨折可通过椎弓根钉棒有效复位固定,撑开复位一定程度上能恢复椎体高度、改善脊柱生理曲度。与传统撑开复位技术相比,改良撑开复位技术更能改善脊柱序列的稳定,并促进骨折愈合,减少术后长期慢性疼痛的发生。Objective To investigate the clinical effecacy of modified distraction and reduction technique in the treatment of Denis B thoracolumbar fracture.Methods A retrospective analysis was conducted on 35 patients with Denis B-type thoracolumbar fractures treated with improved open reduction technique during the undergraduate period from July 2018 to June 2021(the improved group),and a comparison was made with 30 patients treated with traditional open reduction technique during the same period(the traditional group).The surgical time,surgical bleeding volume,efficacy indicators,imaging indicators,and complications at preoperative,immediate postoperative,3 months,6 months,and 12 months were calculated for two groups of patients.Results All patients successfully completed the surgery and received 12-36(23.0±5.4)months of follow-up.There was no statistically significant difference in surgical time and bleeding volume between the two groups(P>0.05).Compared with preoperative,the Cobb angle and anterior edge height of the injured vertebra in both groups were improved after surgery(P<0.05),and the Cobb angle and anterior edge height of the injured vertebra in the traditional group were significantly better than those in the improved group immediately after surgery(P<0.05).However,there was no statistically significant difference between the two groups3-12 months after surgery(P>0.05).The VAS score and ODI index of patients in the improved group were significantly lower than those in the traditional group 3-12 months after surgery,with statistical significance(P<0.05).The fracture healing time of the improved group was significantly shorter than that of the traditional group(P<0.05).There were no broken nails,broken rods,or loose internal fixation in the improved group;one patient in the traditional group experienced the breaking of two screws at the screw head connection four months after surgery.Conclusion Denis B thoracolumbar fracture can be effectively reduced and fixed by pedicle screws.Distraction and reduction can re

关 键 词：Denis B型胸腰椎骨折 撑开复位技术 Wiltse入路 椎弓根螺钉 

分 类 号：R683.2[医药卫生—骨科学]