【摘要】 目的探讨Legacy c MAS腰髂固定系统治疗腰骶部骨折脱位的临床疗效。方法采用Legacy c MAS腰髂固定系统治疗12例腰骶部骨折脱位患者,所有患者均接受后路腰髂固定手术,术前存在骶神经损伤症状者同时行骶管减压术。记录术后并发症,测量术后双下肢长度,摄X线片及重建CT观察骨折复位情况及融合情况。采用视觉模拟评分(VAS)对患者术后残余疼痛进行评估,按照Majeed骨盆功能调查表对患者术后骨盆功能进行评估,采用功能独立性测量(FIM)进行行走能力评估。结果 12例患者均获得随访,时间6~24个月,术后患者疼痛及运动功能均明显改善。VAS评分:术后1个月、3个月、末次随访评分逐渐减少,差异有统计学意义(P<0.01);Majeed评分:术后1个月、3个月、末次随访逐渐增加,差异有统计学意义(P<0.01);FIM评分:术后1个月、3个月、末次随访逐渐增加,差异有统计学意义(P<0.01)。9例在术后6个月骨折愈合,3例术后9个月骨折愈合。无压疮及深静脉血栓并发症发生;2例出现切口感染,予以清创、VSD引流及敏感抗生素治疗后愈合;3例术前有骶神经损伤表现,2例术后症状明显改善,1例术后出现骶神经损伤症状加重,予以脱水、激素及营养神经治疗,手术3个月后逐渐好转。结论 Legacy c MAS腰髂固定系统是一种坚强的三维固定系统,能够重建腰骶段稳定性,是治疗腰骶部骨折脱位的有效方法,初期随访效果良好。更多还原

【Abstract】 Objective To investigate the clinical outcomes of lumbosacral fracture-dislocation using Legacy c MAS lumbo-iliac internal fixation. Methods Data of 12 patients who had been treated with Legacy c MAS lumbo-iliac internal fixation for lumbosacral fracture-dislocation were retrospectively analyzed. Patients with sacral nerve injury had been performed sacral canal decompression. Postoperative complications,postoperative limb lengths,fracture reduction and fusion with X-ray and CT were recorded. The visual analogue scale( VAS) and Majeed functional questionnaire and functional independence measurement( FIM) were used to evaluate clinical outcomes. Results All 12 patients were followed up for 6 ~ 24 months after surgery. Pain and motor function of patients were improved after surgery,the VAS score decreased significantly( P < 0. 01) from 1 month postoperation to 3 months postoperation and final follow-up,while Majeed score and FIM score increased significantly( P < 0. 01). 9 patients fracture healed after 6months and 3 cases healed after 9 months,while all patients didn’t suffer decubitus or deep vein thrombosis complication. 2 patients underwent posterior midline incision infection which eventually healed after debridement and VSD. Of3 patients with sacral nerve injury preoperation,2 patients’ sensory and motor function improved significantly,while one patient experienced neurological deterioration and symptom improved gradually in 3 months after symptomatic treatment. Conclusions Legacy c MAS lumbo-iliac fixation system is a rigid three-dimensional fixation system to reconstruct lumbosacral stability,which is an effective method for the treatment of lumbosacral fracture-dislocation,and the preliminary outcome is satisfactory.更多还原