本文關(guān)鍵詞： 腰椎 胸椎 骨折 出血 輸血 組織工程 骨科植入物 脊柱植入物 壓縮性骨折 Cobb角 傷椎前緣高度 目測(cè)類比評(píng)分 湖北省自然科學(xué)基金　出處：《中國(guó)組織工程研究》2016年04期 　論文類型：期刊論文

【摘要】：背景:經(jīng)后路椎弓根螺釘置入內(nèi)固定是胸腰椎壓縮性骨折常用的修復(fù)方式之一,其固定方式又包括長(zhǎng)節(jié)段固定、短節(jié)段固定及經(jīng)傷椎固定等多種方式。其中經(jīng)傷椎單節(jié)段固定及跨傷椎短節(jié)段固定修復(fù)胸腰椎骨折的臨床療效尚未明確。目的:比較后路經(jīng)傷椎與跨傷椎椎弓根螺釘置入內(nèi)固定修復(fù)胸腰椎壓縮性骨折的穩(wěn)定性。方法:回顧性分析46例胸腰椎壓縮性骨折患者的臨床資料,根據(jù)內(nèi)固定方式分為經(jīng)傷椎固定組(n=21)和跨傷椎固定組(n=25)。對(duì)兩組患者的手術(shù)時(shí)間、術(shù)中出血、術(shù)中輸血、臥床時(shí)間,以及傷椎Cobb角、傷椎前緣高度和目測(cè)類比評(píng)分進(jìn)行長(zhǎng)期隨訪評(píng)價(jià)。結(jié)果與結(jié)論:(1)兩組患者在修復(fù)治療過程中,跨傷椎組在手術(shù)時(shí)間,術(shù)中出血和術(shù)中輸血方面要優(yōu)于經(jīng)傷椎組(P0.05-0.01),經(jīng)傷椎組在臥床時(shí)間上優(yōu)于跨傷椎組(P0.01)。(2)Cobb角和傷椎前緣高度方面,兩組在治療前、治療后和及修復(fù)糾正方面差異未見顯著性意義,而經(jīng)傷椎組在末次隨訪和隨訪丟失方面要優(yōu)于跨傷椎組(P0.05-0.01)。(3)在目測(cè)類比評(píng)分方面,兩組組間比較,治療前、治療后差異均無顯著性意義,而經(jīng)傷椎組在末次隨訪時(shí)要優(yōu)于跨傷椎組,差異有顯著性意義(P0.01)。(4)提示經(jīng)長(zhǎng)期隨訪兩種方式均能獲得較滿意的修復(fù)效果,與跨傷椎組相比經(jīng)傷椎組在維持脊柱的高度和曲度方面優(yōu)勢(shì)更加明顯,可更加有效的重建脊柱生理序列并恢復(fù)其穩(wěn)定性,修復(fù)后腰背痛也可以得到有效控制。
[Abstract]:Background: transpedicular screw fixation is one of the commonly used methods for the repair of thoracolumbar vertebral compression fractures. The clinical effect of short segment fixation and transpedicular fixation on thoracolumbar fractures has not been determined. Objective: to compare the posterior and transpedicular pedicle fixation of thoracolumbar fractures. The stability of thoracolumbar vertebral compression fracture was repaired by screw fixation. Methods: the clinical data of 46 patients with thoracolumbar vertebral compression fracture were analyzed retrospectively. According to the method of internal fixation, the patients were divided into two groups: the injured vertebral fixation group (n = 21) and the transtraumatic vertebral fixation group (n = 25). The operative time, intraoperative bleeding, intraoperative blood transfusion, bed rest time, and Cobb angle of the injured vertebrae were observed in the two groups. The anterior height of injured vertebrae and visual analogies were evaluated for a long time. Results and conclusion: during the repair and treatment of the two groups of patients, the time of operation was observed in the cross-injured vertebra group. The intraoperative bleeding and intraoperative blood transfusion were better than that of the injured vertebra group (P 0.05-0.01), and the trabecular vertebra group was better than the transtraumatic vertebra group in the bed-rest time (P 0.01) and the anterior height of the injured vertebrae. There was no significant difference between the two groups before treatment, after treatment and in repair and correction. The visual analogue score of the injured vertebra group was better than that of the trans-injured vertebra group in the last follow-up and the loss of follow-up. There was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups in visual analogue score. At the last follow-up, the injured vertebra group was better than the trans-injured vertebra group, and the difference was significant (P 0.01). Compared with the trans-injured vertebra group, the injured vertebrae group has more obvious advantages in maintaining the height and curvature of the spine, and can more effectively reconstruct the physiological sequence of the spine and restore its stability, and the backache can also be effectively controlled after the repair.
【作者單位】： 湖北省鄂州市中心醫(yī)院骨科;武漢大學(xué)中南醫(yī)院骨科;
【基金】：2013年湖北省自然科學(xué)基金資助項(xiàng)目(2013CFB269)~~
【分類號(hào)】：R687.3

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