摘要
目的:探讨后路减压AF系统内固定治疗骨质疏松性胸腰椎骨折并脊髓神经损伤的疗效.方法:将113例骨质疏松性胸腰椎骨折并脊髓神经损伤患者随机分为两组:A组(80例)采用后路减压AF系统内固定、后外侧植骨术;B组(33例)单纯行后路减压术;术后两组均给予药物等治疗.分别行X片测量两组术前、术后的伤椎椎管中矢径、椎体高度并行神经功能评定.结果113例患者平均随访19个月,A组术后伤椎前缘高度、后缘高度、椎管中矢径恢复率分别达(90.6±9.31)%、(90.3±13.52)%、(90.4±8.27)%,较术前有显著改善(分别为P＜0.01、P＜0.05、P＜0.01),与B组比较有显著性差异(分别为P＜0.01、P＜0.05、P＜0.01).B组术后与术前比较无显著性差异(P＞0.05).A组骨折复位良好,植骨均融合,有2例断钉,5例螺帽或螺钉松脱;按ASIA损害分级标准7例神经功能未恢复,其余均有1～3级恢复.B组术后伤椎骨折复位不佳,10例神经功能无改善.结论:后路减压AF系统内固定、后外侧植骨操作简便,能有效恢复椎体高度,增大椎管容积,恢复脊柱生理弧度,重建脊柱稳定性,利于神经功能恢复、缓解患者疼痛及减少并发症;结合药物等综合治疗是目前治疗骨质疏松性胸腰椎骨折并脊髓神经损伤的理想方法之一.
Objective：To explore the effects of internal fixation o[AF system and posterior approach decompression on treating thoracolumbar vertebral osteoporotic fractures with spinal cord injury. Methods ：113 patients of thoracolumbar vertebral osteoporotic fractures with spinal cord injury were randanly divided into two groups ：group A of 80 patients were were accepted internal fixation of AF system,posterior approach decompression, posterolateral bone--graft fusion ,and group B of 33 cases were treated with posterior approach decompression,all patients were treated with drugs,etc. The height of injuried vertebra and the sagittal diameters of vertebral canal were measured by using X-ray in preoperative period and postoperative period. The neural function was evaluated at the same time. Results：The average follow-up time was 19 months. The recovery rate of injuried vertebra anterior and posterior border height and vertebral canal sagittal diameters in group A were （90.6±9.31）%, （90.3±13.52）%, （90.4±8.27）% in postoperative period and significantly increased compared with those in preoperative period（P〈0.01,P〈0.05,P〈0. 01）,the effects in group A were more significient than those in group B（P〈0. 01 ,P〈0. 05,P〈0.01. Perfect reduction and spinal fusion were obtained in all cases. Screw breakage in 2 and female screw or screw loosening in 5 in group A . According to AISA motor scoring system, 7 patients of group A and 10 cases＇of group B did not recovery their neural function,the rest improved by 1 to 3 grades . Conclusions：The easy AF system with posterior approach decompressionand posterolateral bone-graft fusion can well restore the height of injt, ried vertebra,enlarge the volume of vertebral canal ,recovery spinal physiologic curve and reconstruct spinal stabilization, thus benefit to the recovery of neural function, remissing the low back pains and reducing the complication of fractures.Associated with drug treatment ,it is one of the ideal treatments for thoracolumbar vertebral osteoporotic fractures with spinal cord injuries.
出处
《中国中医骨伤科杂志》
CAS
2005年第4期23-25,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
骨质疏松
胸腰椎骨折
AF系统
内固定
Osteoporosis Thoracolumbar vertebral fractures AF system Internal fixation
