【摘要】 目的观察和评价分析骶骨骨盆角的测量在腰椎骨折椎弓根钉棒内固定术指导弯棒的临床效果。方法选取我院2016年5月~2017年10月行L2经椎弓根钉棒内固定术的腰椎骨折患者40例的临床资料。所有患者手术前后均摄站立位全脊柱正侧位X射线片。按照不同弯棒指导方法分为实验组和对照组各20例,其中实验组患者通过术前患者SPA的测量指导术中折弯连接棒,术中通过量弧度器械来确定连接棒的弧度。对照组术中通过估算折弯连接棒。统计测量实验组患者术前、术后X射线平片的胸椎后凸角、腰椎前凸角、T1骨盆角、矢状面平衡、骨盆投射角、骶骨倾斜角和骨盆倾斜角;术前术后运用SF-36量表评估两组患者的生活质量、手术时间、切口长度、术中出血量、术后引流量及术后1 d疼痛视觉模拟评分,并进行对比。结果实验组手术时间、切口长度、术中出血量、术后引流量及术后1 d疼痛视觉模拟评分均明显低于对照组;差异有统计学意义(P<0.05)。对于实验组患者腰椎前凸角的变化与骨盆倾斜角、骶骨倾斜角、矢状面平衡存在线性相关,骨盆倾斜角的变化与骶骨倾斜角、身体疼痛维度及总体健康状况维度存在线性相关。就SF-36量表各维度而言,两组患者术后评分均高于术前;差异有统计学意义(P<0.05)。结论骶骨骨盆角的测量能够有效地指导腰椎骨折椎弓根钉棒内固定术时连接棒的折弯弧度,在测量精确性上SPA优于PI,SPA的稳定性有助于推算腰椎的前凸,值得推广应用。更多还原

【Abstract】 Objective To observe and evaluate the clinical effect of the measurement of pelvic Angle of the sacrum in the treatment of lumbar vertebral pedicle screw fixation.Methods The clinical data of 60 patients with lumbar vertebral fracture were retrospectively analyzed from May 2015 to October 2017 in our hospital.All the patients were seated with an X-ray film of the full spinal column before and after the operation.According to different bent rod guidelines are divided into experimental group and control group,30 cases of experimental group patients with preoperative patients with SPA measurement guidance of connecting rod bent art excess radian instrument to determine the radian of connecting rod.The control method was used to estimate the bending joint bar.Statistical measurement experimental group patients with preoperative and postoperative X-ray plain film of lobe after thoracic vertebra,lumbar lordosis Angle,T1 pelvis Angle,sagittal balance,pelvic projection Angle,sacral slope Angle and pelvic tilt Angle;Preoperative evaluation of two groups of patients with postoperative use of SF-36 scale of quality of life,operation time,incision length,intraoperative blood loss,postoperative pain and postoperative 1 d drain visual analogue scale,and comparison.Results The time of operation, incision length,intraoperative blood loss,postoperative drainage and 1 d pain visual simulation score were significantly lower than the control group(P<0.05).In the experimental group patients pelvic tilt Angle with the change of lumbar lordosis Angle,sacral slope Angle,linear correlation between sagittal balance,sacral slope Angle with the change of pelvic tilt Angle, body pain,dimensions and overall health dimension linear correlation. In all dimensions of sf-36 scale, postoperative scores were higher in both groups(P<0.05).Conclusion The sacrum pelvic Angle measurement can effectively guide the lumbar pedicle screw rod fracture fixation connecting rod bending radian, SPA is better than that of PI on measurement accuracy,the stability of the SPA is helpful to calculate the lumbar lordosis,is worthy of popularization and application.更多还原