| 后路截骨矫形长节段固定治疗老年性胸腰段后凸畸形 |
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Received:November 09, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 蒋伟宇 |
JIANG Wei-yu |
浙江中医药大学,浙江 杭州 315040
浙江宁波第六医院,浙江 宁波 315040 |
Zhejiang University of TCM,Hangzhou 315040,Zhejiang,China |
weiyujiang1210@163.com |
| 徐荣明 |
XU Rong-ming |
浙江宁波第六医院,浙江 宁波 315040 |
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| 马维虎 |
MA Wei-hu |
浙江宁波第六医院,浙江 宁波 315040 |
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| 赵刘军 |
ZHAO Liu-jun |
浙江宁波第六医院,浙江 宁波 315040 |
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| 刘观燚 |
LIU Guan-yi |
浙江宁波第六医院,浙江 宁波 315040 |
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| 许楠健 |
XU Nan-jian |
浙江中医药大学,浙江 杭州 315040 |
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| 期刊信息：《中国骨伤》2012年25卷，第4期，第299-302页 |
| DOI：10.3969/j.issn.1003-0034.2012.04.010 |
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目的：探讨后路截骨矫形长节段固定治疗老年性胸腰段后凸畸形的疗效,为老年性胸腰段后凸畸形的外科治疗提供参考。
方法：对2007年4月至2010年4月手术治疗的19例老年性胸腰段后凸畸形的临床资料进行回顾性分析,男12例,女7例；年龄58～74岁,平均62岁；陈旧性骨折11例,强直性脊柱炎3例,脊柱陈旧结核5例。术前神经功能Frankel分级：E级12例,D级4例,C级2例,B级1例。19例患者均采用后路经顶椎截骨矫形长节段内固定术,均进行至少1年以上随访。分析内容包括术前、术后2周及术后1年患者疼痛VAS评分,后凸Cobb角,神经功能和术后并发症。
结果：19例患者术前、术后2周、术后1年VAS评分分别为(7.0±1.2)、(1.1±0.7)、(1.3±0.8)分,后凸Cobb角分别为(44.1±6.9)、(10.9±3.1)、(11.5±2.8) °；VAS评分和后凸Cobb角术前与术后2周比较,差异均有统计学意义(P<0.05),术后2周与术后1年比较,差异均无统计学意义(P>0.05).末次随访时18例(94.7%)符合骨性融合的标准,1例于术后1年截骨面未完全融合,但未出现内固定松动现象。神经症状：D级4例中有3例恢复至E级；C级的2例恢复至D级； B级1例恢复至C 级。
结论：后路截骨矫形长节段固定术治疗老年胸腰段后凸畸形,可取得良好的近期疗效。 |
| [关键词]:胸椎 腰椎 脊柱后凸 畸形 骨折固定术,内 |
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| Posterior osteotomy and long-segment internal fixation for the treatment of senile thoracolumbar kyphotic deformity |
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Abstract:
Objective:To explore the therapeutic effects of posterior osteotomy and long-segment internal fixation in the treatment of senile thoracolumbar kyphotic deformity and provide the reference for operative treatment.
Methods:From April 2007 to April 2010,19 older patients with thoracolumbar kyphotic deformity were respectively analyzed. There were 12 males and 7 females with an average age of 62 years(ranged,58 to 74 years). Among patients,11 cases were old fracture,3 cases were ankylosing spondylitis,and 5 cases were old spinal tuberculosis. According to preoperative Frankel classification,12 cases were grade E,4 cases were grade D,2 cases were C and 1 case was grade B. All patients were treated by posterior osteotomy and long-segment internal fixation and followed up above 1 year. VAS score preoperative,2 weeks and 1 year after operation,Cobb's angle,nerve function and complication were observed.
Results:VAS score preoperative,2 weeks and 1 year after operation separately was(7.0±1.2),(1.1±0.7) and(1.3±0.8 );while Cobb's angle separately was (44.1±6.9),(10.9±3.1) and(11.5±2.8);there was significant difference in VAS score and Cobb's angle between preoperative and 2 weeks after operation(P<0.05);while no significant difference between 2 weeks and 1 year after operation(P>0.05). Eighteen cases met the standard of osseous fusion,1 case occurred nonunion,but not looseness 1 year after operation. Nerve function:3 cases changed grade E from 4 cases with grade D,2 cases with grade C changed to grade D,1 case with grade B changed to grade C.
Conclusion:Posterior osteotomy and long-segment internal fixation for the treatment of senile thoracolumbar kyphotic deformity can receive a good short-time effects. |
| KEYWORDS:Thoracic vertebrae Lumbar vertebrae Kyphosis Abnormalities Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蒋伟宇,徐荣明,马维虎,赵刘军,刘观燚,许楠健.后路截骨矫形长节段固定治疗老年性胸腰段后凸畸形[J].中国骨伤,2012,25(4):299~302 |
| 英文格式: | JIANG Wei-yu,XU Rong-ming,MA Wei-hu,ZHAO Liu-jun,LIU Guan-yi,XU Nan-jian.Posterior osteotomy and long-segment internal fixation for the treatment of senile thoracolumbar kyphotic deformity[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(4):299~302 |
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