【摘要】：目的:評價前后路短節(jié)段固定融合治療腰椎縱向劈裂骨折的臨床效果和安全性。方法:回顧性分析中南大學(xué)湘雅二醫(yī)院脊柱外科2005年3月至2013年5月采用的前后路短節(jié)段固定融合治療的13例腰椎縱向劈裂骨折患者臨床資料,對所有患者的矯正情況進(jìn)行隨訪,采用疼痛視覺模擬量表(visual analogue scale,VAS)評分、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)對腰椎功能進(jìn)行評估。結(jié)果:隨訪時間為24~60個月,平均42個月;手術(shù)時間185~300min,平均248 min;術(shù)中失血量為600~1 500 m L,平均950 m L。所有患者術(shù)后均獲得功能及自我形象的改善,在Cobb角評估方面,術(shù)后2 d,12個月和末次隨訪測量Cobb角較手術(shù)前均有明顯改善,差異均有統(tǒng)計學(xué)意義(P0.05);VAS評分和ODI評估術(shù)后2 d,12個月和末次隨訪測量結(jié)果較之術(shù)前均有改善,差異均有統(tǒng)計學(xué)意義(P0.05)。術(shù)后12個月與末次隨訪的評估結(jié)果相比,差異無統(tǒng)計學(xué)意義(P0.05)。根據(jù)美國脊髓損傷協(xié)會(ASIA)分級標(biāo)準(zhǔn),在末次隨訪時,術(shù)前8例D級患者中6例恢復(fù)至E級,其中3例未見進(jìn)一步恢復(fù);術(shù)前2例C級中1例恢復(fù)至D級,1例恢復(fù)至E級。所有病例骨折均獲愈合,愈合時間為3~6個月,平均4.5個月;術(shù)中3例有硬膜撕裂,術(shù)中給予修補;無神經(jīng)血管損傷并發(fā)癥病例。結(jié)論:短節(jié)段傷椎置釘和旋棒復(fù)位是腰椎縱向劈裂不穩(wěn)定骨折較好的手術(shù)選擇。
[Abstract]:Objective: to evaluate the clinical effect and safety of anterior and posterior short segment fixation and fusion in the treatment of lumbar longitudinal split fracture. Methods: the clinical data of 13 patients with lumbar longitudinal split fracture treated by anterior and posterior short segment fixation and fusion from March 2005 to May 2013 in Xiangya second Hospital of Central South University were analyzed retrospectively. the clinical data of 13 patients with longitudinal split fracture of lumbar vertebrae were treated by anterior and posterior short segment fixation and fusion from March 2005 to May 2013. The correction of all patients was followed up. The lumbar vertebrae function was evaluated by pain visual analog scale (visual analogue scale,VAS) score and Oswestry dysfunction index (Oswestry disability index,ODI). Results: the follow-up time was 24 脳 60 months (mean 42 months), the operation time was 185 min / 300 min, and the average intraoperative blood loss was 600 脳 1 500 min;, with an average of 950 mL. The function and self-image of all patients were improved after operation. On the 2nd day after operation, the Cobb angle measured at 12 months and at the last follow-up was significantly improved compared with that before operation, the difference was statistically significant (P 0.05). On the 2nd day after operation, the results of VAS score and ODI were improved at 12 months and at the last follow-up, and the difference was statistically significant (P 0.05). There was no significant difference between the evaluation results of 12 months after operation and the last follow-up (P 0.05). According to the (ASIA) grading standard of American Spinal Cord injury Association, 6 of 8 grade D patients recovered to grade E before operation, 3 of them did not recover further, 1 of 2 patients of grade C recovered to grade D before operation, and 1 of them recovered to grade E. The fracture healed in all cases, the healing time was 3 鈮，

本文編號：2481113