原位转棒复位治疗胸腰段单节段压缩骨折
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作者Author单位AddressE-Mail
张宇鹏 ZHANG Yu-peng 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China hnronald@hotmail.com 
任东风 REN Dong-feng 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
吴叶 WU Ye 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
王华东 WANG Hua-dong 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
马超 MA Chao 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
商卫林 SHANG Wei-lin 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
吴闻文 WU Wen-wen 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
侯树勋 HOU Shu-xun 解放军总医院第一附属医院骨科,北京 100048 Department of Orthopaedics,the First Affiliated Hospital,the General Hospital of PLA,Beijing 100048,China  
期刊信息:《中国骨伤》2012年,第25卷,第10期,第838-841页
DOI:10.3969/j.issn.1003-0034.2012.10.013
基金项目:
中文摘要:

目的:探讨原位转棒复位结合伤椎置钉、短节段固定治疗胸腰段单节段压缩骨折的可行性及临床疗效.

方法:2008年12月至2010年5月,收治外伤所致胸腰段压缩骨折患者12例,其中男9例,女3例;年龄24~52岁,平均35.8岁.骨折节段:T11 2例,T12 2例,L1 6例,L2 2例.所有患者排除骨质疏松症及病理性骨折,无神经损伤症状.收集术前、术后5 d、末次随访(至少12个月)时影像资料,对伤椎Cobb角、椎体压缩比例、内固定物状况进行观察.

结果:12例患者均获得随访,时间12~30个月,平均19个月.所有病例获得骨性融合,无假关节形成,未见内固定物松动、断裂.矢状面后凸校正Cobb角由术前的(25.8±9.4)°矫正至术后5 d的(6.7±2.3)°,末次随访时的(6.9±2.6)°;椎体压缩比例由术前的(42.5±10.4)%恢复至术后5 d的(7.5±3.9)%,末次随访时的(8.4±4.5)%;术后5 d与术前相比差异有统计学意义(P < 0.05),末次随访时与术后5 d相比差异无统计学意义(P > 0.05).

结论:原位转棒复位结合伤椎置钉、短节段固定操作简便,可使胸腰段单节段压缩骨折获得并保持良好复位,是一种安全有效的治疗方法.
【关键词】脊柱骨折  胸椎  腰椎  骨折固定术,内
 
Surgical treatment of thoracolumbar single compression fracture by using in situ rod rotation reduction
ABSTRACT  

Objective:To evaluate the efficacy and clinical outcome of the treatment of thoracolumbar single compression fracture by using in situ rod rotation reduction and short segment pedicle screw at the fracture level.

Methods:From December 2008 to May 2010,12 cases of traumatic thoracolumbar single compression fracture(T11-L2) were treated,including 9 males and 3 females,with an average age of 35.8 years old(ranging from 24 to 52). There were 2 case with T11 fracture,2 cases with T12,6 cases with L1 and 2 cases with L2,without osteoporosis,pathological fractures or neurologic deficits. Radiographic data were collected preoperatively,5 days postoperatively and at last follow-up(at least 12 months). Cobb's angle,vetebral compression ratio,internal fixation state were observed.

Results:All patients were followed up from 12 to 30 months postoperatively,with an average of 19 months. There was no pseudoarticulation and solid bone fusion was achieved in all cases. There were no complications such as loosening or rupturing of internal fixation and so on. Sagittal kyphotic Cobb angle was corrected from preoperative (25.8±9.4)° to postoperative (6.7±2.3)° and (6.9±2.6)° at last follow-up. The percentage of vertebral compression was corrected from preoperative (42.5±10.4)% to postoperative(7.5±3.9)% and (8.4±4.5)% at last follow-up.There was significant difference between the postoperative data and preoperative data(P < 0.05),while the difference was not significant between the postoperative data and the last follow-up(P > 0.05).

Conclusion:The thoracolumbar single compression fracture can obtain and maintain a good restoration by using the technic of in situ rod rotation reduction and short segment pedicle screw at the fracture level. The technique should be highly recommended.
KEY WORDS  Spinal fracture  Thoracic vertebrae  Lumbar vertebrae  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:张宇鹏,任东风,吴叶,王华东,马超,商卫林,吴闻文,侯树勋.原位转棒复位治疗胸腰段单节段压缩骨折[J].中国骨伤,2012,25(10):838~841
英文格式:ZHANG Yu-peng,REN Dong-feng,WU Ye,WANG Hua-dong,MA Chao,SHANG Wei-lin,WU Wen-wen,HOU Shu-xun.Surgical treatment of thoracolumbar single compression fracture by using in situ rod rotation reduction[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(10):838~841
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