个体化伤椎单侧置钉联合植骨术治疗胸腰椎爆裂骨折Individualized unilateral pedicle screw placement combined intrabody bone grafting on fractured vertebrae for thoracolumbar burst fractures
李世梁;杜兰翔;崔晓荣;孙海东;李悫;李育敏;钟锐;
摘要(Abstract):
[目的]观察胸腰椎爆裂骨折患者行个体化伤椎单侧置钉联合伤椎内植骨术的临床疗效。[方法]回顾性分析2016年4月~2018年2月胸腰椎爆裂骨折行伤椎置钉短节段固定患者60例,根据术中是否经椎弓根伤椎体内植骨分为二组,30例为植骨组,其余30例为非植骨组。比较两组临床资料。[结果]两组患者均顺利完成手术。植骨组手术时间长于非植骨组,差异有统计学意义(P<0.05);术中出血量和术口长度比较差异无统计学意义(P>0.05)。所有患者术后随访12~33个月。两组患者VAS评分均随时间推移显著减少(P<0.05),术后相同时间点两组间VAS评分差异无统计学意义(P>0.05)。影像检查方面,术后两组椎体前缘压缩率、Cobb角均较术前显著改善(P<0.05),术后1周时两组间差异无统计学意义(P>0.05),末次随访时植骨组显著优于非植骨组(P<0.05),植骨组有6例,非植骨组有24例残留"空壳"征,差异有统计学意义(P<0.05)。植骨组无内固定松动、断裂等,非植骨组4例椎弓根钉根部断裂,3例连接棒断裂,差异有统计学意义(P<0.05)。[结论]后路个体化伤椎单侧置钉联合打压植骨术治疗胸腰椎爆裂骨折可显著恢复并维持伤椎椎体高度及Cobb角,促进骨折愈合。
关键词(KeyWords): 胸腰椎爆裂骨折;后路短节段固定;伤椎置钉;经椎弓根椎体内植骨
基金项目(Foundation): 江西省赣州市科学技术局指导性科技计划项目(编号:GZ2017ZSF298);; 赣州市卫生计生系统第二批优秀青年医学人才培养对象项目(编号:赣市卫计科教字[2018]16号)
作者(Author): 李世梁;杜兰翔;崔晓荣;孙海东;李悫;李育敏;钟锐;
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参考文献(References):
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