摘要
目的探讨经椎弓根注射硫酸钙椎体成形辅助椎弓根内固定治疗胸腰椎骨折的可行性和疗效。方法采用经椎弓根注射硫酸钙椎体成形辅助椎弓根内固定治疗胸腰椎骨折28例,其中男21例,女7例,年龄25～56岁。术后观察症状改善情况,并且在术前、术后和末次随访时拍摄胸腰椎正侧位X线片,观察骨折复位和稳定情况。结果所有病例均顺利完成手术,无症状性并发症发生。术前椎体前缘、中央和后缘高度丢失率分别为(44.76±4.40)%、(26.04±3.71)%和(1.96±0.23)%,术后分别为(6.72±1.29)%、(5.36±1.62)%和(1.40±0.32)%,前二者与术后相比存在显著差异(P<0.05)。26例获得随访,随访时间12～30个月,平均20个月。内固定无断钉、松动。VAS评分由术前8.5分降至1分。末次随访椎体前缘、中央和后缘高度丢失率分别为(6.87±1.69)%、(5.80±1.47)%和(1.78±0.24)%,与术后相比无显著性差异(P>0.05)。结论经椎弓根注射硫酸钙椎体成形辅助椎弓根内固定治疗胸腰椎骨折,是一种微创、安全、有效的方法。它可重建脊柱稳定,减少并发症,提高疗效。
Objective To explore the feasibility and clinical efficacy of shortsegment pedicle screw fixation combined with calcium sul- fate vertebroplasty in patients with thoracolumbar fractures. Methods Twentyeight patients with thoracolumbar fractures were treated by vertebroplasty reinforced with calcium sulfate injection and short - segment pedicle screw fixation. Twenty - one patients were males and 7 females, aged from 25 to 56 years old . The symptoms improvements were observed. Plain X- rays were taken pre- and post-operatively and at the final follow- up to measure vertebral height. Results All patients underwent surgery uneventfully. No symptomatic complications were found. The loss ratios of anterior, mid and posterior vertebral height were （44.76 ± 4.40） % , （26.04 ± 3.71 ） % and （ 1.96 ± 0.23） % respectively before surgery, and （6.72 ± 1. 19） % , （5.36 ± 1.62） % and （ 1.40 ± 0.32） % post - operatively. The pre- and post - operative loss ratios of vertebral height were significantly different （P 〈 0.05）. Of the 26 patients followed up for an average of 20 months, there were no breakage of pedicle screw and loosening of instrument. Pain score by visual analog scale （VAS） reduced from 8.5 to 1.0. The loss ratios of anterior vertebral, mid and posterior vertebral height were （6.87 ±1.69） % , （5.80 ± 1.47） % and （ 1.78 ± 0.24） % respectively, and the difference was not significant compared with that of immediately after operation （P 〉 0.05）. Conclusion Reinforcement of short - segment pedicle fixation with calcium sulfate vertebroplasty for the treatment of patients with thoracolumbar fracture may achieve and maintain kyphosis correction, increase and maintain anterior vertebral height, decrease the instrument failure rate, and provides better postoperative outcomes. It is a minimally invasive, safe and effective method.
出处
《中国骨与关节损伤杂志》
2008年第8期620-622,共3页
Chinese Journal of Bone and Joint Injury
关键词
胸腰椎
硫酸钙
椎体成形
椎弓根螺钉
固定
Thoracolumbar
Calcium sulfate
Vertebroplasty
Pedicle screw
Fix
