拓源;郝定均;贺宝荣;杨俊松;刘团江;李厚坤;葛朝元;杨彦玲;

• 1:西安交通大学附属红会医院脊柱外科
• 2:延安大学医学院

摘要(Abstract)：

[目的]提出一种评估骨质疏松性胸腰椎骨折骨不连(nonunion of osteoporotic thoracolumbar fractures,NOTF)伴伤椎失稳的方法,并探讨短节段骨水泥强化椎弓根螺钉固定术治疗NOTF伴伤椎失稳的临床疗效。[方法]通过对比站立位侧位X线片和仰卧位正中矢状位CT片的伤椎后凸角变化来评估伤椎的稳定性,定义伤椎后凸角变化≥11°为伤椎失稳。回顾性分析2013年1月~2016年10月应用短节段骨水泥强化椎弓根螺钉固定术治疗的21例单节段NOTF伴伤椎失稳患者的临床资料,男3例,女18例。临床疗效评估采用视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI);影像学评估采用伤椎前缘高度比和局部后凸Cobb角。[结果]随访12~36个月,平均(19.14±7.73)个月。所有患者背部疼痛均得到明显改善,术后1个月和末次随访时VAS评分、ODI、伤椎前缘高度比及局部后凸Cobb角与术前相比均得到明显改善,差异具有统计学意义(P<0.05);术后1个月与末次随访比较,各评价指标差异无统计学意义(P>0.05)。无骨水泥移位、内固定松动或断裂等并发症发生。[结论]对比站立侧位X线片和仰卧位CT正中矢状位片下伤椎后凸角的变化是评估NOTF伴伤椎失稳的一种简单、可行的方法,短节段骨水泥强化椎弓根螺钉固定术治疗NOTF伴伤椎失稳安全有效,临床效果满意。

关键词(KeyWords)： 骨质疏松;脊柱;骨折;骨不连;失稳

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(编号:81472098)

作者(Author): 拓源;郝定均;贺宝荣;杨俊松;刘团江;李厚坤;葛朝元;杨彦玲;

Email:

DOI:

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