文本内容:
椎弓根螺钉内固定联合椎体成形修复单节段胸腰椎骨质疏松性爆裂性骨折张 亮，王静成，冯新民，王永祥，杨建东，陶玉平，张圣飞，黄吉军苏北人民医院，江苏省扬州市 225001Pediclescrewfixationcombinedwithvertebroplastyforsingle-levelthoracolumbarosteoporoticburstfracturesZhangLiangWangJing-chengFengXin-minWangYong-xiangYangJian-dongTaoYu-pingZhangSheng-feiHuangJi-junNorthernJiangsuPeople’sHospitalYangzhou225001JiangsuProvinceChina摘要 背景对于椎管内有骨块占位的骨质疏松性胸腰椎爆裂性骨折，单纯椎体成形术难以解除椎管内占位及纠正脊柱后凸畸形，且骨水泥渗漏发生率高，使其成为其应用的相对禁忌证，而传统椎弓根螺钉系统固定存在手术创伤大、螺钉松动及椎体高度丢失等问题目的观察经肌间隙入路短节段椎弓根螺钉内固定联合椎体成形治疗单节段胸腰椎骨质疏松性爆裂性骨折的疗效方法回顾分析经肌间隙入路短节段椎弓根螺钉内固定联合椎体成形治疗单节段胸腰椎骨质疏松性爆裂性骨折患者31例内固定后通过疼痛目测类比评分评估腰背部疼痛情况、ODI评分评估腰背部功能情况、SF-36健康调查评分表评估生活质量、胸腰椎正侧位片评估伤椎椎体前缘高度比值、伤椎Cobb角改善情况、Frankel评分评估神经功能情况及并发症结果与结论内固定置入过程均顺利完成，未发生脊髓神经损伤所有患者随访12-36个月，平均
24.5个月，伤椎均达满意复位，平均伤椎椎体前缘高度及Cobb角得到明显改善，腰背部疼痛明显缓解，腰背部功能明显改善，生活质量明显提高，以上所有指标治疗后均显著改善，与治疗前比较差异有显著性意义P
0.05，内固定后1周和内固定后1年比较差异无显著性意义P
0.05内固定后2例患者出现骨水泥渗漏，其中椎体前缘及椎间隙处少量骨水泥渗漏各1例，但均无临床症状随访期间，无内固定松动、断裂等，无新发骨折说明联合应用后路经肌间隙入路短节段椎弓根螺钉内固定及伤椎椎体成形，不仅能有效恢复并维持伤椎椎体高度及强度，重建脊柱稳定性，明显缓解腰背部疼痛，还可以使患者获得满意的腰背部功能，显著提高生存质量，是治疗伴椎管内占位的骨质疏松性胸腰椎爆裂性骨折的有效方法中国组织工程研究http://www.crter.org/杂志出版内容重点人工关节http://www.crter.org/；骨植入物；脊柱http://www.crter.org/；骨折http://www.crter.org/；内固定；数字化骨科；组织工程http://www.crter.org/全文链接关键词 植入物http://www.crter.org/CN/abstract/abstract
8107.shtml； 脊柱植入物http://www.crter.org/CN/abstract/abstract
8107.shtml； 骨质疏松http://www.crter.org/CN/abstract/abstract
8107.shtml； 胸腰椎http://www.crter.org/CN/abstract/abstract
8107.shtml； 爆裂性骨折http://www.crter.org/CN/abstract/abstract
8107.shtml； 椎体成形http://www.crter.org/CN/abstract/abstract
8107.shtml； 内固定http://www.crter.org/CN/abstract/abstract
8107.shtml； 肌间隙http://www.crter.org/CN/abstract/abstract
8107.shtml； Abstract BACKGROUND: Vertebroplastyalonecannotreliefspinalcanalencroachmentandkyphosismalformationfortreatmentofosteoporoticthoracolumbarfractures.Moreovertheoccurrencerateofbonecementleakageishighwhichbecomesacontraindicationforitsapplication.Pediclescrewinternalfixationalonemayincreasethetraumascrewlooseningandhighincidenceoflatekyphosisdeformity.OBJECTIVE: Toobservethetherapeuticeffectsofshort-segmentpediclescrewfixationthroughparaspinalapproachcombinedwithvertebroplastyforsingle-levelthoracolumbarosteoporoticburstfractures. METHODS: Aretrospectivestudywasconductedin31casesreceivingshort-segmentpediclescrewfixationthroughparaspinalapproachcombinedwithvertebroplastyforsingle-levelthoracolumbarosteoporoticburstfractures.Afterfixationclinicaloutcomeswereevaluatedmainlywithuseofvisualanalogscaleforlowerbackpain.FunctionsoflowerbackpainwereassessedusingOswestryDisabilityIndexquestionnaire.Qualityoflife wasevaluatedusing36-ItemShortFormHealthSurvey.ThoracolumbaranteroposteriorandlateralradiographswereutilizedtoassessanteriorvertebralheightratioandtheimprovementofCobbangle.Frankelscorewasappliedtoevaluateneurologicalfunctionandcomplications. RESULTSANDCONCLUSION: Alloperationsweresuccessfullycompletedwithnospinalcordornervedamage.Allpatientswerefollowedupforamean
24.5months12-36months.Fracturedvertebraereachedsatisfactoryreduction.TheaveragevertebralbodyheightandCobbanglesignificantlyimproved.Thelowbackpainrelieved.Lowbackfunctionandqualityoflifeimprovedsignificantly.AlloftheaboveindicatorssignificantlyimprovedP
0.
05.Nosignificantdifferencesweredetectedbetween1-weekpostoperationand1-yearpostoperationP
0.
05.Afterfixationtwopatientsaffectedbonecementleakageincludingoneinanteriorvertebralbodyandoneinintervertebralspace.Howevertheydidnothaveclinicalsymptoms.Duringfollow-upnolooseningorbreakagenonewfracturesoccurred.Theseresultsindicatedthatthecombinationofthistechniquewithvertebroplastyplusinternalfixationthroughparaspinalapproachnotonlyrestoredandmaintainedvertebralheightandstrengthreconstructedspinalstabilizationobviouslylessenedlowbackpainbutalsocouldmakepatientsgetsatisfactorylowbackfunctionandimprovedthequalityoflife.Itisaneffectivemethodforosteoporoticthoracolumbarfractureswithspinalcanalencroachment.中国组织工程研究http://www.crter.org/杂志出版内容重点人工关节http://www.crter.org/；骨植入物；脊柱http://www.crter.org/；骨折http://www.crter.org/；内固定；数字化骨科；组织工程http://www.crter.org/全文链接Keywords spinehttp://www.crter.org/CN/abstract/abstract
8107.shtml; osteoporosishttp://www.crter.org/CN/abstract/abstract
8107.shtml; lumbarvertebraehttp://www.crter.org/CN/abstract/abstract
8107.shtml; thoracicvertebraehttp://www.crter.org/CN/abstract/abstract
8107.shtml; fracturesbonehttp://www.crter.org/CN/abstract/abstract
8107.shtml; methylmethacrylateshttp://www.crter.org/CN/abstract/abstract
8107.shtml; 中图分类号: R318http://www.crter.org/CN/article/showArticleBySubjectScheme.docode=R318\t_blank 基金资助: 卫生部医药卫生科技发展研究中心课题W2012ZT14通讯作者: 冯新民，主任医师，教授，硕士生导师，苏北人民医院，江苏省扬州市225001 作者简介:张亮，男，1983年生，江苏省泰州市人，2012年解放军第二军医大学毕业，博士，主治医师，讲师，主要从事脊柱外科方面的研究引用本文: 张亮王静成冯新民等.椎弓根螺钉内固定联合椎体成形修复单节段胸腰椎骨质疏松性爆裂性骨折[J]. 中国组织工程研究20141817:2722-
2727.ZhangLiangWangJing-chengFengXin-minetal.Pediclescrewfixationcombinedwithvertebroplastyforsingle-levelthoracolumbarosteoporoticburstfractures[J].ChineseJournalofTissueEngineeringResearch20141817:2722-
2727.。
个人认证
优秀文档
获得点赞 0
