| 后路椎弓根钉结合椎体成形治疗胸腰椎爆裂骨折 |
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈之青 |
CHEN Zhi-qing |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
czqchen2008@sina.com |
| 谢金兔 |
XIE Jin-tu |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
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| 顾晓民 |
GU Xiao-min |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
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| 谢国盛 |
XIE Guo-sheng |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
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| 胡大鹏 |
HU Da-peng |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
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| 王荣 |
WANG Rong |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
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| 陆建民 |
LU Jian-min |
杭州师范大学附属医院杭州市第二人民医院骨科,浙江 杭州 310015 |
Department of Orthopaedics,the Second People's Hospital of Hangzhou,the Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第2期，第102-106页 |
| DOI：10.3969/j.issn.1003-0034.2010.02.009 |
| 基金项目: |
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中文摘要:
目的：探讨后路椎弓根钉固定结合终板撑开钳复位终板、自固化磷酸钙骨水泥椎体成形治疗胸腰椎爆裂骨折的临床价值。
方法：采用后路椎弓根螺钉内固定结合经椎弓根终板撑开钳复位中央终板、自固化磷酸钙骨水泥椎体成形治疗胸腰椎骨折爆裂患者30例(32个椎体),男22例，女8例；年龄25～71岁，平均47岁。骨折节段：T11 1椎，T12 5椎，L1 14椎，L2 8椎，L3 2椎，L4 1椎，L5 1椎。按Denis分型：A型4椎，B型25椎，C型1椎，D型1椎，E型 1椎。通过X线片测量术前、术后及随访8个月时椎体前缘相对高、椎体成角，了解随访期间内固定失败及后凸畸形再发情况；通过CT测量术后椎体内空隙率，通过CT重建片了解术前中央终板骨折塌陷及术后复位情况。
结果：所有患者随访8～15个月，平均12个月，伤椎前缘相对高度：术前40.1%,术后98.2%,术后8个月97.8%,术后较术前显着改善，而术后8个月与术后无显着性差异。伤椎椎体成角：术前18.3°，术后2.7°，术后8个月3.2°，术后较术前显着改善，而术后8个月与手术后无显着性差异；未发生内固定失败情况及后凸畸形再发；术后椎体内空隙率3.1%,中央终板骨折塌陷复位满意。
结论：后路椎弓根螺钉固定结合自固化磷酸钙骨水泥椎体成形是治疗胸腰椎骨折较理想的方法，能有效防止内固定失败和椎体再发后凸畸形，同时终板撑开钳对中央终板具有良好的复位作用。 |
| 【关键词】脊柱骨折 骨折固定术，内 并发症 治疗结果 |
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| Posterior short-segment pedicle screw fixation combined with vertebroplasty for the treatment of thoracolumbar burst fractures |
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ABSTRACT
Objective: To evaluate the clinical efficacy of posterior short-segment pedicle screw fixation combined reduction of central end-plate by end-plate expand clamp and vertebroplasty with calcium phosphate cement for the treatment of thoracolumbar burst fractures.
Methods: Thirty patients with thoracolumbar burst fractures were treated with posterior pedicle screw fixation combined reduction of central end-plate by end-plate expand clamp and vertebroplasty with calcium phosphate cement. There were 22 males and 8 females with an average of 47 years(range from 25 to 71 years). Segment of fracture had 1 case in T11,5 in T12,14 in L1,8 in L2,2 in L3,1 in L4,1 in L5. According to Denis typing,4 cases were type A,25 type B,1 type C,1type D,1 type E. The relative anterior height of vertebral body and the vertebral angle were measured before and after operation and during the follow-up period(8 months after operation) through X-ray,the failure of internal fixation and recurrent kyphosis were evaluated during the follow-up period. Vertebral intracorporeal gap was measured by CT images after operation and the central end-plate fracture and reduction were observed by the reconstructed CT images(sagittal and coronary) before and after operation.
Results: All patients were followed up from 8 to15 months with an average of 12 months. Relative anterior height of vertebral body and vertebral angle were well restored after operation,and there was no significant change between after operation and 8 months after operation. Preoperative,postoperative and 8 months after operation,relative anterior height of vertebral body respectively was 40.1%,98.2%,97.8%,vertebral angle respectively was 18.3°，2.7°，3.2°。 No failure of internal fixation and recurrent kyphosis were found during the follow-up period. The vertebral intracorporeal gap was about 3.1% and reduction of central endplate fracture was satisfactory.
Conclusion: Posterior short-segment pedicle screw fixation combined with vertebroplasty with calcium phosphate cement can provide excellent reduction of post-traumatic segmental kyphosis and restore vertebral body height in the fracture level,prevent the failure of internal fixation which is an ideal method for the treatment of thoracolumbar burst fractures. |
| KEY WORDS Spinal fractures Fracture fixation,internal Complications Treatment outcome |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈之青,谢金兔,顾晓民,谢国盛,胡大鹏,王荣,陆建民.后路椎弓根钉结合椎体成形治疗胸腰椎爆裂骨折[J].中国骨伤,2010,23(2):102~106 |
| 英文格式: | CHEN Zhi-qing,XIE Jin-tu,GU Xiao-min,XIE Guo-sheng,HU Da-peng,WANG Rong,LU Jian-min.Posterior short-segment pedicle screw fixation combined with vertebroplasty for the treatment of thoracolumbar burst fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(2):102~106 |
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