本文選題：胸腰椎骨折 + 空殼現(xiàn)象��； 參考：《中國脊柱脊髓雜志》2017年03期

【摘要】：目的 :探討胸腰椎骨折復(fù)位術(shù)后椎體"空殼現(xiàn)象"的相關(guān)因素。方法 :對2013年1月~2015年12月我科行后路椎弓根釘棒系統(tǒng)復(fù)位內(nèi)固定術(shù)治療的116例胸腰椎單節(jié)段骨折患者進行回顧性分析。分別記錄患者的年齡、性別、病程、術(shù)前椎體壓縮程度、術(shù)前矢狀面Cobb角、骨折類型、骨密度、傷椎置釘、骨折撐開復(fù)位情況、椎體復(fù)位程度、螺釘位置等相關(guān)因素,觀察患者術(shù)后椎體"空殼現(xiàn)象"的發(fā)生情況,應(yīng)用單因素和多因素Logistic回歸分析研究各因素與椎體"空殼現(xiàn)象"發(fā)生的相互關(guān)系。結(jié)果:116例患者中有72例患者術(shù)后發(fā)生椎體"空殼現(xiàn)象",發(fā)生率為62.1%。單因素分析結(jié)果顯示患者骨折撐開復(fù)位情況、椎體復(fù)位程度、術(shù)前椎體壓縮程度及骨密度與術(shù)后椎體"空殼現(xiàn)象"的發(fā)生有明顯的相關(guān)性(P0.05),而患者的年齡、性別、病程、骨折類型、術(shù)前矢狀面Cobb角、傷椎置釘情況、螺釘位置與術(shù)后椎體"空殼現(xiàn)象"的發(fā)生無相關(guān)性(P0.05)。多因素分析結(jié)果顯示患者術(shù)前椎體壓縮程度及骨密度是影響術(shù)后椎體"空殼現(xiàn)象"發(fā)生的獨立危險因素。結(jié)論:胸腰椎骨折復(fù)位術(shù)后出現(xiàn)椎體"空殼現(xiàn)象"受多種因素影響,其中椎體壓縮程度和骨密度可能是造成上述問題的主要原因。
[Abstract]:Objective: to investigate the factors related to the phenomenon of hollow shell of vertebral body after reduction of thoracolumbar fractures. Methods: 116 patients with single segment thoracolumbar fractures treated by posterior pedicle screw and rod system from January 2013 to December 2015 were retrospectively analyzed. Age, sex, course of disease, degree of vertebral compression, preoperative sagittal Cobb angle, type of fracture, bone mineral density, traumatic screw insertion, open reduction of fracture, degree of reduction of vertebral body, screw position, and so on were recorded respectively. The occurrence of "empty shell phenomenon" in vertebral body after operation was observed, and the relationship between each factor and the occurrence of "empty shell phenomenon" of vertebral body was studied by univariate and multivariate logistic regression analysis. Results among 116 cases, 72 cases had "empty shell" of vertebral body after operation, the incidence rate was 62.1%. The results of univariate analysis showed that there was a significant correlation between the open reduction of fracture, the degree of reduction of vertebral body, the degree of compression of vertebral body before operation and the occurrence of "empty shell phenomenon" of vertebral body after operation (P0.05), and the age, sex, course of disease of the patient, and the degree of reduction of vertebral body. The type of fracture, preoperative Cobb angle of sagittal plane, screw placement and screw position had no correlation with the occurrence of "empty shell phenomenon" after operation (P0.05). The results of multivariate analysis showed that the degree of vertebral compression and bone mineral density were independent risk factors for the occurrence of "empty shell phenomenon" after operation. Conclusion: after reduction of thoracolumbar fracture, the phenomenon of "empty shell" of vertebral body is affected by many factors, among which the degree of vertebral compression and bone mineral density may be the main causes of the above problems.
【作者單位】： 四川省自貢市第四人民醫(yī)院骨一科;
【基金】：四川省衛(wèi)生和計劃生育委員會項目(編號:16PJ596) 自貢市科技局項目(編號:2016SF04)
【分類號】：R687.3

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