【摘要】 目的分析经皮椎弓根螺钉内固定恢复胸腰椎爆裂骨折椎管形态的效果。方法采用经皮椎弓根螺钉内固定治疗35例胸腰椎爆裂骨折伴骨块突入椎管患者。记录手术时间、术中出血量、住院时间、并发症发生情况、疼痛VAS评分、伤椎高度百分比、椎管侵占率。结果患者均获得随访,时间6～24个月。手术时间35～65 min,术中出血量20～30 ml,住院时间7～12 d。术中均未发生椎弓根螺钉误入椎管、神经损伤等并发症,术后均未发生切口感染,切口均一期愈合。伤椎高度百分比、疼痛VAS评分术后2 d及术后6个月均明显优于术前(P <0.05);椎管侵占率术后2 d明显低于术前(P <0.05)。结论采用经皮椎弓根螺钉内固定治疗胸腰椎爆裂骨折可有效恢复椎体高度,复位椎体后缘骨块,改善椎管形态和容积。更多还原

【Abstract】 Objective To analyze the effect of percutaneous pedicle screw internal fixation in the restoration of spinal canal morphology of thoracolumbar burst fractures. Methods The 35 cases who suffered from thoracolumbar burst fractures with bone block protruding into the spinal canal were treated by percutaneous pedicle internal internal fixation. The operation time,intraopeative blood loss,time of hospital stay,complications,pain VAS,the percentage of injured vertebral height,and spinal canal invasion rate were recorded. Results The patients were followed up for 6 ～24 months. The operation time was 35 ～ 65 min,the intraoperative blood loss was 20 ～ 30 ml,and the hospitalization time was 7 ～ 12 d. There were no complications such as pedicle screw straying into the spinal canal and nerve injury during the operation,no incision infection occurred after operation,and the incision healed in the first stage. The percentage of injured vertebrae height and pain VAS at 2 d,6 months after operation were significantly better than those before operation( P < 0. 05); the invasion rate of spinal canal at 2 d after operation was significantly lower than those before operation( P < 0. 05). Conclusions In treatment of thoracolumbar burst fractures,the percutaneous pedicle screw internal fixation can effectively restore vertebral height,restore the bone block of vertebral posterior edge,and improve the morphology and volume of spinal canal.更多还原