[1]宋西正,康禹,王程,等.脊柱外固定动静结合治疗胸腰椎骨折的临床研究[J].中国中医骨伤科杂志,2018,26(12):13-17.
　SONG Xizheng KANG Yu WANG Cheng YI Guoliang YI Xin YI Ming WANG Wenjun.Clinical Research of Dynamic and Static Combination in Percutaneous External Trans-Pedicle Fixation for Thoracolumbar Vertebral Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(12):13-17.
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脊柱外固定动静结合治疗胸腰椎骨折的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年12期
页码:
13-17
栏目:
临床研究
出版日期:
2018-12-03

文章信息/Info

Title:
Clinical Research of Dynamic and Static Combination in Percutaneous External Trans-Pedicle Fixation for Thoracolumbar Vertebral Fracture
文章编号:
1005-0205(2018)12-0013-05
作者:
宋西正1; 康禹1; 王程1; 易国良1; 易新1; 易明1; 王文军1△
1南华大学附属第一医院(湖南 衡阳,421001) △通信作者 E-mail:wwj1202@hotmail.com
Author(s):
SONG Xizheng1 KANG Yu1 WANG Cheng1 YI Guoliang1 YI Xin1 YI Ming1 WANG Wenjun1△
1The First Hospital Affiliated to South China University, Hengyang 421001,Hunan China.
关键词:
脊柱外固定;  动静结合;  胸腰椎骨折;  临床研究
Keywords:
percutaneous external trans-pedicle fixation;  dynamic and static combination;  thoracolumbar vertebral fracture;  clinical research
分类号:
R683.2
文献标志码:
A
摘要:
目的:探讨脊柱外固定动静结合治疗胸腰椎骨折的临床疗效。方法:选取2013年5月至2017年5月胸腰椎骨折病例120例(120个椎体):其中男73例,女47例; 年龄19～55岁,平均年龄(38.05±9.78)岁; 随访时间3～12个月。椎体分布:胸椎55例(T93个,T107个,T1119个,T1226个); 腰椎65例(L123个,L217个,L419个,L56个)。分为对照组64例、试验组56例,对照组采用钉棒内固定手术方法,试验组采用脊柱外固定方法,比较两组手术后椎体前缘高度丢失率、Oswestry功能障碍指数(ODI)、视觉模拟评分(VAS)以及骨痂形成率。结果:所有患者均获得随访,随访时间3～12个月,平均9个月。试验组术后1周及末次随访时的椎体前缘高度丢失率均明显低于对照组,术后1周及末次随访时试验组ODI及VAS评分明显低于对照组,3个月后及末次随访时试验组的骨痂形成率均明显高于对照组,差异均有统计学意义(P<0.05)。结论:脊柱外固定动静结合治疗胸腰椎骨折的复位效果及骨折愈合率均优于传统钉棒内固定,具有良好的临床疗效。
Abstract:
Objective: To discuss the clinical efficacy of dynamic and static combination in percutaneous external trans-pedicle fixation for thoracolumbar vertebral fracture. Methods: There are 120 patients with thoracolumbar vertebral fracture(120 vertebral bodies)which were selected from May 2012 to May 2017, including 73 males and 47 females. Among the 120 vertebral bodies, there are 55 thoracic vertebrae(T9: 3, T10:7, T11: 19, T12: 26)and 65 lumbar vertebras(L1: 23, L2: 17, L4: 19, L5: 6). All cases were divided into control group(64 cases)and experimental group(56 cases). The control group took traditional pedicle screw fixation and the experimental group took percutaneous external trans-pedicle fixation. We made comparison between two groups on 4 aspects, namely the height of the injury vertebrae, the score of ODI and VAS, and the rate of porosis. Results: All 120 patients were followed up for 3～12 months with an average of 9 months. The loss rate of the injury vertebral body in experimental group was lower than that of control group at one week after operation and the last follow-up. The experimental group's ODI and VAS score was also lower than that of the control group at one week after operation and the last follow-up. At the time of 3 months post-operation and the last follow-up, the porosis rate of the experimental group was higher than that of the control group. The difference was statistically significant(P<0.05). Conclusion: The percutaneous external trans-pedicle fixation combined with dynamic and static combination is effective on fracture reduction and porosis than traditional pedicle screw fixation for treating thoracolumbar vertebral fracture.

参考文献/References:

[1] Hu Z,Zhou Y,Li N,et al.Correlations between posterior longitudinal ligament status and size of bone fragment in thoracolumbar burst fractures[J].Int J Clin Exp Med,2015,8(2):2754-2759.
[2] Wood KB,Buttermann GR,Phukan R,et al.Operative compared with non-operative treatment of a thoracolumbar burst fracture without neurological deficit:a prospective,randomized study with follow-up at sixteen to twenty-two years[J].J Bone Joint Surg Am,2015,97(1):3-9.
[3] Gelb D,Ludwing S,Karp JE,et al.Successful treatment of thoracolumbar fractures with short-segment pedicle instrumentation[J].Spine Disord,2010,23(25):293-301.
[4] Reinhold M,Knop C,Beisse R,et al.Operative treatment of traumatic fractures of the thoracic and lumber spinal column:Part Ⅲ:follow up data[J].Unfallchirurg,2009,112(3):294-316.
[5] Payer M.“Minimally invasive” lumbar spine surgery:a critical review[J].Acta Neurochir(Wien).2011,153(7):1455-1459.
[6] 郭彦涛,杨少锋,邓博.“动静结合”理论在腰背筋膜炎治疗中的应用[J].中国中医骨伤科杂志,2014,22(8):33-35.
[7] 吴威强,陈远明,黄中飞,等.脊柱外固定器治疗胸腰椎骨折的疗效观察[J].中国临床新医学,2017,10(11):1036-1039.
[8] 闵朋,张燕萍,曹洪.CT引导下骨水泥注入辅助人工虎骨粉修复骨质疏松性脊椎压缩性骨折:骨痂生长及骨愈合评价[J].中国组织工程研究,2015,3(19):335-339.
[9] 王琦.中医原创思维的文化背景与哲学基础[J].中华中医药杂志,2012,8(27):2120-2122.
[10] 张向东,曹向阳,王鹏,等.中医骨伤科的“动静结合”思想[J].中医临床研究,2015,7(25):37-39.
[11] 孙贵香,郭艳幸,何清湖,等.平乐正骨动静互补平衡论——平乐正骨理论体系之平衡理论研究[J].中医正骨,2012,24(11):865-869.
[12] Shen T,Qiu L,Chang H,et al.Cyclic tension promotes osteogenic differentiation in human periodontal ligament stemcells[J].Int J Clin Exp Pathol,2014,7(11):7872-7880.
[13] Chen CS,Chen WJ,Cheng CK,et al.Failure analysis of broken pedicle screws on spinal instrumentation[J].Med Eng Phys,2005,27(6):487-496.
[14] 欧军,王文军,张美超,等.新型脊柱外固定器的生物力学有限元分析[J].中国临床解剖学杂志,2008,26(2):199-201.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金面上项目(81272055)
更新日期/Last Update: 2018-12-03