[1]孟繁军 崔彦彬△ 李涛 牛占岭 朱利 周兴华 郭德立.经伤椎椎弓根植骨结合椎弓根钉内固定治疗胸腰椎骨折35例[J].中国中医骨伤科杂志,2017,25(06):41-44.
　MENG Fanjun CUI Yanbin LI Tao NIU Zhanling ZHU Li ZHOU Xinghua GUO Deli.35 Cases of Transpedicular Intervertebral Bone Graft in Injured Vertebrae and Pedicle Screw Fixation for the Treatment of Thoracolumbar Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(06):41-44.
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经伤椎椎弓根植骨结合椎弓根钉内固定治疗胸腰椎骨折35例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年06期
页码:
41-44
栏目:
临床研究
出版日期:
2017-07-08

文章信息/Info

Title:
35 Cases of Transpedicular Intervertebral Bone Graft in Injured Vertebrae and Pedicle Screw Fixation for the Treatment of Thoracolumbar Fracture
文章编号:
1005-0205(2017)06-0041-04
作者:
孟繁军1 崔彦彬1△ 李涛1 牛占岭1 朱利1 周兴华1 郭德立1
1.河北保定市第一中心医院骨二科(河北 保定,071000)
△.通信作者 E-mail:bdmengzi.2008@163.com
Author(s):
MENG Fanjun1 CUI Yanbin1△ LI Tao1 NIU Zhanling1 ZHU Li1 ZHOU Xinghua1 GUO Deli1
1.Department Ⅱ of Orthopaedics, Baoding First Central Hospital, Baoding 071000,China.
关键词:
经伤椎椎弓根植骨;  椎弓根钉内固定;  胸腰椎骨折
Keywords:
transpedicular intervertebral bone graft;  pedicle screw fixation;  thoracolumbar fracture
分类号:
R638.2
文献标志码:
A
摘要:
目的:探讨经伤椎椎弓根植骨结合椎弓根钉内固定治疗胸腰椎骨折的临床效果。方法:按照患者实际选择治疗方案将65例胸腰椎骨折患者分为观察组(经伤椎椎弓根植骨+椎弓根钉内固定)35例和对照组(椎弓根钉内固定)30例,比较两组患者治疗情况及预后效果。结果:两组患者治疗后椎体前缘高度均明显高于治疗前,Cobb角均明显低于治疗前,分别为(95.33±8.47)%与(49.85±5.22)%,(4.32±1.06)°与(27.33±3.58)°,(94.01±8.30)%与(49.97±5.30)%,(5.10±1.13)°与(27.29±3.62)°(P<0.05); 两组患者治疗后椎体前缘高度、Cobb角以及神经功能提高1级、2级所占比例差异无统计学意义,分别为(95.33±8.47)%与(94.01±8.30)%,(4.32±1.06)°与(5.10±1.13)°,20.00%与6.67%,11.43%与10.00%(P>0.05); 观察组患者随访结束后椎体前缘丢失高度、Cobb角丢失度、ODI以及疼痛程度均明显低于对照组,分别为(1.55±0.20)%与(7.31±1.46)%,(1.25±0.38)°与(7.39±1.52)°,(15.46±4.38)与(24.16±4.59),60.00%与33.33%(P<0.05); 观察组患者随访期间内固定失效率明显低于对照组,分别为0.00%与20.00%(P<0.05)。结论:经伤椎椎弓根植骨结合椎弓根钉内固定术后椎体前缘高度及Cobb角丢失更少,腰背部功能及疼痛改善效果更佳,内固定失效率更低,值得临床推广。
Abstract:
Objective: To explore the clinical effect of transpedicular intervertebral bone graft in injured vertebrae and pedicle screw fixation for the treatment of thoracolumbar fracture. Methods: 65 cases of thoracolumbar fracture were divided into experimental group(35 cases of transpedicular intervertebral bone graft in injured vertebrae and pedicle screw fixation)and control group(30 cases of pedicle screw fixation). The treatment and prognosis of the two groups were compared.Results: After treatment, the anterior vertebral height of the two groups was significantly higher than that before treatment,(95.33±8.47)% vs(49.85±5.22)%,(94.01±8.30)% vs(49.97±5.30)%, and Cobb's angle were significantly lower than that before treatment(4.32±1.06)° vs(27.33±3.58)°,(5.10±1.13)°vs(27.29±3.62)°(P<0.05).There was no significant difference in the height of anterior vertebral body height, Cobb 's angle and nerve function recovery rate between the two groups after treatment,(95.33±8.47)% vs(94.01±8.30)%,(4.32±1.06)° vs(5.10±1.13)°,20.00% vs 6.67%,11.43% vs 10.00%(P>0.05). By the end of follow-up, the anterior vertebral height loss, Cobb 's angle loss degree, ODI and degree of pain in the experimental group were significantly lower than those in the control group(1.55±0.20)% vs(7.31±1.46)%,(1.25±0.38)°vs(7.39±1.52)°,15.46±4.38 vs 24.16±4.59,60.00% vs 33.33%(P<0.05).The failure rate in the experimental group was significantly lower than that in the control group during the follow-up period(0.00% vs 20.00%)(P<0.05). Conclusion: Transpedicular intervertebral bone graft in injured vertebrae and pedicle screw fixation has many advantages such as lower vertebral height and Cobb's angle loss, the better waist back function and pain improvement effect, the lower internal fixation failure rate. It is worthy of clinical promotion.

参考文献/References:

[1] 晏礼,宋文慧,王春强.胸腰椎骨折分类及治疗研究新进展[J].中国矫形外科杂志,2013,21(12):1202-1205.
[2] 夏天,王雷,董双海,等.182例下腰椎骨折特点的描述性分析[J].中国矫形外科杂志,2012,20(4):298-302.
[3] 徐海涛,王文己.胸腰椎骨折的手术治疗进展[J].医学综述,2013,19(7):1240-1243.
[4] 梁伟之,张海波,贾俊峰,等.椎弓根钉置入治疗胸腰椎骨折[J].中国组织工程研究,2012,16(44):8308-8315.
[5] 潘兵,张志敬,宋舟锋,等.胸腰椎骨折伤椎短椎弓根钉固定的生物力学研究[J].中国矫形外科杂志,2013,21(4):368-372.
[6] 胡海刚,王清,谭伦.伤椎椎弓根置钉植骨治疗胸腰椎骨折的应用现状及进展[J].中国组织工程研究,2012,16(48):9074-9078.
[7] 史晓林,杨永明,张昊,等.经伤椎椎弓根植骨结合椎弓根螺钉治疗胸腰椎骨折远期疗效[J].国际骨科学杂志,2011,32(4):265-266.
[8] Sekharappa V,Sait A.Simple and economical method to create thoracolumbar burst fracture in a calf spine model[J].Asian Spine J,2016,10(1):6-13.
[9] Haq MI,Khan SA,Aurangzeb A,et al.Radiological outcome of transpedicular screws fixation in the management of thoracolumbar spine injury[J].J Ayub Med Coll Abbottabad,2015,27(1):171-173.
[10] Jo DJ,Kim KT,Kim SM,et al.Single-stage posterior subtotal corpectomy and circumferential reconstruction for the treatment of unstable thoracolumbar burst fractures[J].J Korean Neurosurg Soc,2016,59(2):122-128.
[11] 黄剑峰,宁锦龙,岑定善.胸腰椎骨折的微创手术进展[J].中国医药导报,2012,9(9):16-18.
[12] 廖兴华,冯梅,张维成,等.后路减压、椎弓根钉复位固定经伤椎椎弓根植骨治疗胸腰椎压缩骨折[J].临床骨科杂志,2013,16(2):136-138.
[13] 贺新宁,欧晔灵,杜志勇,等.经皮椎弓根钉内固定治疗胸腰椎骨折[J].实用骨科杂志,2014,20(6):484-487.
[14] Wu XG,Huang J,Jiang YQ,et al.Anatomical study on vertebral artety and its application in transpedicle screw fixation for upper cervical vetebrae[J].China J Ortho Traum,2014,27(9):772-774.
[15] 赵佶寅,沈进稳.胸腰椎骨折椎弓根螺钉内固定系统的生物力学研究进展[J].医学综述,2012,18(9):1369-1371.
[16] Wang G,Fu S,Shen H,et al.Clinical application of atlas translaminar screws fixation in treatment of atlatoaxial instability[J].China J Rep Recon Surg,2013,27(10):1210-1213.
[17] 曾红生,陈子华,陈建威,等.经伤椎椎弓根螺钉置入内固定修复胸腰椎骨折:远期效果及生物力学分析[J].中国组织工程研究,2016,20(4):571-576.
[18] Hueng DY,Chung TT,Chuang WH,et al.Biomechanical effects of cage positions and facet fixation on initial stability of the anterior lumbar interbody fusion motion segment[J].Spine(Phila Pa 1976),2014,39(13):E770-E776.
[19] 黄剑峰,宁锦龙,易椿均,等.微创经伤椎椎弓根植骨附加伤椎椎弓根螺钉内固定治疗胸腰椎骨折[J].中华临床医师杂志:电子版,2011,5(22):6642-6647.
[20] 纪福利,王树海,于海芳,等.经伤椎椎弓根钉固定结合经椎弓根植骨治疗胸腰椎爆裂骨折[J].河北医学,2014,20(4):662-664.

更新日期/Last Update: 2017-06-15