| 胸椎椎弓根螺钉治疗上胸椎严重骨折 |
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Received:May 06, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 盛孙仁 |
SHENG Sun-ren |
温州医学院附属第二医院骨科，浙江 温州 325000 |
Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 王向阳 |
WANG Xiang-yang |
温州医学院附属第二医院骨科，浙江 温州 325000 |
Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 徐华梓 |
XU Hua-zi |
温州医学院附属第二医院骨科，浙江 温州 325000 |
Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
spinexu@163.com |
| 毛方敏 |
MAO Fang-min |
温州医学院附属第二医院骨科，浙江 温州 325000 |
Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 池永龙 |
CHI Yong-long |
温州医学院附属第二医院骨科，浙江 温州 325000 |
Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 余可和 |
YU Ke-he |
温州医学院附属第二医院骨科，浙江 温州 325000 |
Department of Orthopaedics,the Second Affiliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 期刊信息：《中国骨伤》2011年24卷，第1期，第34-36页 |
| DOI：10.3969/j.issn.1003-0034.2011.01.010 |
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目的：探讨胸椎椎弓根螺钉治疗上胸椎严重骨折的方法及疗效。
方法：自2000年3月至2008年6月回顾性分析18例上胸椎严重骨折患者的临床资料，男10例，女8例；年龄20～76岁，平均34.3岁。按Denis分型：爆裂骨折15例，骨折伴脱位3例。损伤节段：T1-T2 2例，T3 2例，T3-T4 2例，T4-T5 8例，T5-T6 2例。Wolter外伤性椎管狭窄分型：Ⅰ型9例，Ⅱ型7例，Ⅲ型2例。Frankel分级：A级5例，B级4例，C级2例，D级4例，E级3例。均采用后路胸椎椎弓根螺钉固定治疗，手术前后通过影像观察Cobb角及椎管狭窄度，通过Frankel分级的变化评估神经症状，通过CT复查术后椎弓根螺钉与椎弓根的位置。
结果：18例患者均获随访，时间1～6年，平均2.3年。Cobb角由术前的(26.50±5.62)°改善为术后的(21.20±3.54)°(P<0.05);椎管内占位改善率61%.术后Frankel分级：A级4例，B级2例，C级3例，D级3例，E级6例，手术前后Frankel分级有明显改善(P<0.05).CT复查示椎弓根螺钉88.5%(69/78)位于椎弓根内。
结论：后路椎弓根螺钉固定方法是坚强、安全、有效的胸椎严重骨折的治疗方法。 |
| [关键词]:脊柱骨折 骨折固定术，内 回顾性研究 |
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| Treatment of severe upper thoracic vertebrae fractures with thoracic pedicle screw |
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Abstract:
Objective: To investigate the clinical effect and method of thoracic pedicle screw for the treatment of severe upper thoracic fractures.
Methods: From March 2000 to June 2008,the clinical data of 18 patients with severe upper thoracic fractures were respectively analyzed. Among them,10 males and 8 females,the ranging in age from 20 to76 with an average of 34.3 years. According to the classification of Denis,15 cases were burst fracture and 3 cases were burst-dislocation. Segments of injury:T1-T2 had in 2 cases,T3 in 2,T3-T4 in 2,T4-T5 in 8,T5-T6 in 2. According to the classification of Wolter traumatic spinal stenosis,9 cases were typeⅠ，7 were typeⅡ，2 were typeⅢ。 According to the classification of Frankel,5 cases were grade A,4 were grade B,2 were grade C,4 were grade D,3 were grade E. All fractures were fixed with posterior thoracic pedicle screw. After treatment,the Cobb angle and the degree of spinal stenosis were measured by image data;the nerve functions were analyzed by Frankel grade,the locations of pedicle screw and the pedicle were observed by CT.
Results: All patients were followed up from 1 to 6 years with an average of 2.3 years. Cobb angle was improved from preoperative(26.50±5.62)° to postoperative(21.20±3.54)°(P<0.05);the improvement rate of the spinal stenosis was 61%. Frankel grade obtained significantly improvement(P<0.05),grade A was in 4 cases,grade B in 2,grade C in 3,grade D in 3,grade E in 6. CT showed about 88.5%(69/78) of the pedicle screw located within the pedicle.
Conclusion: The posterior fixation with thoracic pedicle screw is a strong,safe and effective method in treating severe thoracic fractures. |
| KEYWORDS:Spinal fractures Fracture fixation,internal Retrospective studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 盛孙仁,王向阳,徐华梓,毛方敏,池永龙,余可和.胸椎椎弓根螺钉治疗上胸椎严重骨折[J].中国骨伤,2011,24(1):34~36 |
| 英文格式: | SHENG Sun-ren,WANG Xiang-yang,XU Hua-zi,MAO Fang-min,CHI Yong-long,YU Ke-he.Treatment of severe upper thoracic vertebrae fractures with thoracic pedicle screw[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(1):34~36 |
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