【摘要】 目的探讨经皮伤椎置钉内固定治疗急性胸腰椎骨折的方法及临床疗效。方法采用经皮伤椎置钉内固定治疗35例急性胸腰椎骨折患者。观察指标:手术时间,术中出血量,术前、术后、术后1个月及末次随访时伤椎Cobb角、伤椎压缩程度及Wolter指数。术后1个月和末次随访时采用ODI对患者恢复情况进行评价。结果患者均获得随访,时间12～24个月。手术时间85～105 min,术中出血量50～70 ml。术前15例ASIA分级为D级的患者术后1周内神经功能均恢复至E级。术后Cobb角、伤椎压缩程度、Wolter指数均优于术前(P <0. 001);末次随访时Cobb角、伤椎压缩程度、Wolter指数与术后比较差异均无统计学意义(P>0. 05)。ODI术后1个月、末次随访时均优于术前(P <0. 001)。结论经皮伤椎置钉内固定治疗急性胸腰椎骨折疗效满意。更多还原

【Abstract】 Objective To investigate the method and clinical effect of percutaneous vertebral pedicle screw fixation in the treatment of acute thoracolumbar fractures. Methods The 35 patients with acute thoracolumbar fracture were treated with percutaneous pedicle screw fixation. The observation indicators included: the time of operation,the bleeding volume during operation,the Cobb angle,vertebral compression degree and Wolter index of injured vertebrae were recorded before operation,after operation,1 month after operation and at the last follow-up. ODI was used to evaluate the recovery of patients at 1 month and at the end of follow-up. Results All patients were followed up for12 ～ 24 months. The operation time ranged from 85 min to 105 min,and the bleeding volume ranged from 50 ml to 70 ml. In 15 patients with ASIA grade D,the neurological function recovered to E level within 1 week after operation.The postoperative Cobb angle,vertebral compression degree and Wolter index were better than the preoperative( P <0. 001); at the end of the follow-up,Cobb angle,vertebral compression degree,Wolter index,compared with the postoperative,the result showed no significant difference( P > 0. 05). The ODI score was better than the preoperative at the postoperative 1 month and last follow-up after operation( P < 0. 001). Conclusions Percutaneous internal fixation with vertebral pedicle screws for the treatment of simple acute thoracolumbar fractures is satisfactory.更多还原