[1]郑安华,徐正生,方崇斌.椎弓根螺钉固定联合与非联合伤椎置钉治疗单节段胸腰椎骨折的对比研究[J].中医正骨,2012,24(12):20-22.
　ZHENG An-hua*,XU Zheng-sheng,FANG Chong-bin..A retrospective comparison of pedicle screw fixation integrated and nonintegrated with pedicle fixation at the level of the fracture for treatment of thoracolumbar single-segment fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(12):20-22.
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椎弓根螺钉固定联合与非联合伤椎置钉治疗单节段胸腰椎 骨折的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期数:
2012年12期
页码:
20-22
栏目:
脊柱损伤
出版日期:
2012-12-20

文章信息/Info

Title:
A retrospective comparison of pedicle screw fixation integrated and nonintegrated with pedicle fixation at the level of the fracture for treatment of thoracolumbar single-segment fractures
作者:
郑安华; 徐正生; 方崇斌
浙江省台州市中医院,浙江 台州 318000
Author(s):
ZHENG An-hua*; XU Zheng-sheng; FANG Chong-bin.
*Traditional Chinese Medical Hospital of Taizhou City,Taizhou 318000,Zhejiang,China
关键词:
脊柱骨折 胸椎 腰椎 内固定器 治疗; 临床研究性
Keywords:
Spinal fractures;  Thoracic vertebrae;  Lumbar vertebrae;  Internal fixators;  Therapies; investigational
摘要:
目的:评价椎弓根螺钉固定联合与非联合伤椎置钉治疗单节段胸腰椎骨折的临床疗效和安全性。方法:回顾性分析76例单节段胸腰椎骨折患者的病历资料,采用联合伤椎置钉治疗者39例(A组),采用非联合伤椎置钉治疗者37例(B组)。比较2组患者术前及术后1年的伤椎高度比[伤椎高度比=(伤椎前缘高度÷伤椎上下椎体前缘平均高度)×100%]、Cobb's角及腰痛视觉模拟评分,并记录患者术后及随访期间并发症的发生情况。结果:①伤椎高度比。2组患者术前伤椎高度比[(45.90±15.30)%,(46.80±16.30)%]比较,差异无统计学意义(t=0.721,P=0.712); A组患者术后1年与术前伤椎高度比的差值[(40.30±12.60)%]大于B组[(29.60±15.80)%],差异有统计学意义(t=3.273,P=0.004)。②Cobb's角。2组患者术前Cobb's角[(17.40°±3.40°),(16.90°±3.20°)]比较,差异无统计学意义(t=0.559,P=0.657); A组患者术后1年与术前Cobb's角的差值(11.20°±2.80°)大于B组(6.20°±2.60°),差异有统计学意义(t=3.974,P=0.001)。③腰痛评分。2组患者术前腰痛视觉模拟评分[(7.20±2.30)分,(7.40±2.50)分]比较,差异无统计学意义(t=0.363,P=0.733); A组患者术后1年与术前腰痛视觉模拟评分的差值[(5.30±3.20)分]大于B组[(3.60±1.30)分],差异有统计学意义(t=2.114,P=0.032)。④并发症。2组患者均未出现切口感染、深部感染、血管神经损伤及内固定失败等并发症。结论:椎弓根螺钉固定联合伤椎置钉固定在恢复单节段胸腰椎骨折患者伤椎高度、纠正后凸畸形及缓解腰椎疼痛方面优于非联合伤椎置钉固定,而且安全性与后者相当。
Abstract:
Objective:To evaluate the clinical curative effect and safety of pedicle screw fixation integrated and nonintegrated with pedicle fixation at the level of the fracture for treatment of thoracolumbar single-segment fractures.Methods:The medical records of 76 patients with thoracolumbar single-segment fractures were analyzed retrospectively,39 patients(group A)underwent pedicle screw fixation integrated with pedicle fixation at the level of the fracture,while the others(group B)underwent pedicle screw fixation nonintegrated with pedicle fixation at the level of the fracture.The fractured vertebral body height ratio[(anterior height of fractured vertebral body/average anterior height of upper-lower fractured vertebral body)×100%],Cobb's angle and visual analogue scores(VAS)of lumbago were compared between the two groups before the operation and 1 year after the operation,and the complications in the postoperative and follow-up periods were recorded.Results:①Fractured vertebral body height ratio:there was no statistical difference in pre-operative height ratio of fractured vertebral body[(45.90±15.30)%,(46.80±16.30)%]between the 2 groups(t=0.721,P=0.712); while difference value of fractured vertebral body height ratio between 1 year post-operation and pre-operation for group A[(40.30±12.60)%]was greater than that of group B[(29.60±15.80)%]and there was statistical difference between them(t=3.273,P=0.004).②Cobb's angle:there was no statistical difference in pre-operative Cobb's angle[(17.40°±3.40°),(16.90°±3.20°)]between the 2 groups(t=0.559,P=0.657); while Cobb's angle D-value between 1 year post-operation and pre-operation of group A(11.20°±2.80°)was greater than that of group B(6.20°±2.60°)and there was statistical difference between them(t=3.974,P=0.001).③Lumbago VAS:there was no statistical difference in pre-operative lumbago VAS[(7.20±2.30),(7.40±2.50)]between the 2 groups(t=0.363,P=0.733); while D-value of lumbago VAS between 1 year post-operation and pre-operation of group A(5.30±3.20 was greater than that of group B(3.60±1.30)and there was statistical difference between them(t=2.114,P=0.032).④Complications:no complications such as incision infection,deep infection,neurovascular injury and failed internal fixation were found in the 2 groups.Conclusion:The therapy of pedicle screw fixation integrated with pedicle fixation at the level of the fracture has better effect on the aspects of fractured vertebral body height recovery,kyphotic deformity correction and pain relief in lumbar spine for the patients with thoracolumbar single-segment fractures compared with the therapy which nonintegrated with pedicle fixation at the level of the fracture,and the two methods have similar safety.

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更新日期/Last Update: 2012-12-20