| 后路复位椎间植骨融合治疗胸腰椎骨折脱位 |
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投稿时间：2012-07-17
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| 作者 | Author | 单位 | Address | E-Mail |
| 廖旭昱 |
LIAO Xu-yu |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
Department of Spine Surgery, the Sixth Hospital of Ningbo, Ningbo 315040, Zhejiang, China |
liaoxuyumehf@sina.com |
| 周雷杰 |
ZHOU Lei-jie |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
Department of Spine Surgery, the Sixth Hospital of Ningbo, Ningbo 315040, Zhejiang, China |
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| 马维虎 |
MA Wei-hu |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
Department of Spine Surgery, the Sixth Hospital of Ningbo, Ningbo 315040, Zhejiang, China |
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| 韩金明 |
HAN Jin-ming |
宁波市第六医院脊柱外科,浙江 宁波 315040 |
Department of Spine Surgery, the Sixth Hospital of Ningbo, Ningbo 315040, Zhejiang, China |
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| 期刊信息：《中国骨伤》2012年，第25卷，第12期，第988-991页 |
| DOI：10.3969/j.issn.1003-0034.2012.12.005 |
| 基金项目: |
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中文摘要:
目的：探讨后路复位固定椎体间植骨融合治疗胸腰椎骨折脱位的临床疗效。
方法：自2004年8月至2009年5月,采用后路复位椎弓根螺钉内固定,椎体间植骨融合治疗胸腰椎骨折脱位24例,男18例,女6例;年龄24～56岁,平均38.2岁。均为外伤所致,交通伤14例,高处坠落6例,重物砸伤2例,横向挤压伤2例。AO分型:B1型12例,B2型5例,B3型2例,C1型3例,C2型2例。损伤部位:T10,11 1例,T11,12 2例,T12L1 5例,L1,2 8例,L2,3 2例,L3,4 4例,L4,5 2例。神经功能Frankel分级:A级5例,B级9例,C级8例,D级2例。术后随访骨折脱位复位、植骨愈合和神经功能恢复情况。
结果：所有患者获得随访,时间8～33个月,平均16个月。手术时间3.0～5.8 h,平均3.7 h;术中失血500～1 800 ml,平均860 m1.Cobb角由术前20°～43°(32.6±3.7)°,恢复至术后7°～17°(13.7±2.4)°;伤椎椎体前缘高度由术前相邻正常椎体的(32%～78%)(41.0±11.6)%,恢复至术后84%～89%(87.6±2.3)%.5例Frankel A级患者,3例术后无恢复,1例恢复至B级,1例恢复至C级;9例Frankel B级患者,5例恢复到C级,3例恢复至D级,1例恢复至E级;8例Frankel C级患者,5例恢复到D级,3例恢复至E级;2例Frankel D级患者恢复正常。植骨面均获骨性融合,无内固定物松动、断裂等并发症。
结论：后路复位椎体间植骨融合治疗胸腰段脊柱骨折脱位能在恢复脊柱正常序列的基础上获得满意的脊柱融合。 |
| 【关键词】胸椎 腰椎 骨折 脱位 脊柱融合 |
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| Posterior reduction and interbody fusion for the treatment of thoracolumbar fractures and dislocations |
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ABSTRACT
Objective:To explore efficacy of posterior reduction and interbody fusion in treating thoracolumbar fractures and dislocations.
Methods:From August 2004 to May 2009,24 patients (18 males and 6 females with an average of 38.2 years,ranged 24 to 56 years old) were treated. Among them,14 cases were by traffic accident,6 cases were falling down,2 cases were heavy hit,2 cases were transverse crush. According to AO classification,12 cases were type B1,5 cases B2,2 cases B3,3 cases C1,2 cases C2. One cases in T10,11,2 cases in T11,12,5 cases in T12L1,8 cases in L1,2,2 cases in L2,3,4 cases in L3,4,2 cases in L4/5. Acoording to Frankle classification,5 cases in grade A,9 cases in grade B,8 cases in grade C and 2 cases in grade D. The reduction,graft healing and recovery of nervous function were followed up.
Results:All patients were followed up from 8 to 33 months with an average of 16 months. The operation time was for 3.0 to 5.8 hours,meaned 3.7 h,and mean blood loss was 860 ml ( ranged,500 to 1 800 ml). Cobb angle improved from preoperative (32.6±3.7)° to postoperative (13.7±2.4)°。 The anterior high of fractured vertebrae increased from preoperative (41.0±11.6)% to postoperative (87.6±2.3)% .Three cases of 5 cases with Frankle A were not recovery,1 case changed to grade B,1 case changed to grade C;Five cases of 9 cases with Frankle B were changed to grade C,3 cases to grade D,1 case changed to grade E;Five cases of 8 cases with Frankle C were changed to Grade D,3 cases to Grade E;Two cases with Frankle D were recoved to normal. Planting bone surface got bone fusion,and no internal fixation lossen,dislocation occurred.
Conclusion:Posterior reduction and rigid interbody fusion for the treatment of thoracolumbar fractures and dislocations can receive satisfactory fusion based on recovering normal spinal sequence. |
| KEY WORDS Thoracic vertebrae Lumbar vertebrae Fractures Dislocations Spinal fusion |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 廖旭昱,周雷杰,马维虎,韩金明.后路复位椎间植骨融合治疗胸腰椎骨折脱位[J].中国骨伤,2012,25(12):988~991 |
| 英文格式: | LIAO Xu-yu,ZHOU Lei-jie,MA Wei-hu,HAN Jin-ming.Posterior reduction and interbody fusion for the treatment of thoracolumbar fractures and dislocations[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(12):988~991 |
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