[1]张惠城,刘展亮,陈嘉裕,等.后路复位固定椎体间植骨融合治疗老年胸腰椎骨折脱位疗效及对患者神经功能的影响*[J].陕西医学杂志,2018,(11):1451-1453.
　Zhang Huicheng,Liu Zhanliang,Chen Jiayu,et al.Effect of posterior fixation and interbody fusion in the treatment of thoracolumbar fractures and dislocation in elderly patients and its effect on neurological function[J].,2018,(11):1451-1453.
点击复制

后路复位固定椎体间植骨融合治疗老年胸腰椎骨折脱位疗效及对患者神经功能的影响*
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2018年11期
页码:
1451-1453
栏目:
临床研究
出版日期:
2018-11-29

文章信息/Info

Title:
Effect of posterior fixation and interbody fusion in the treatment of thoracolumbar fractures and dislocation in elderly patients and its effect on neurological function
文章编号:
0.3969/j.issn.1000-7377.2018.11.025
作者:
张惠城; 刘展亮; 陈嘉裕; 杨志发; 杨永迁
广东省梅州市人民医院骨科（梅州514021）
Author(s):
Zhang Huicheng;  Liu Zhanliang;  Chen Jiayu; et al.
Department of Orthopedics, Meizhou People’s Hospital in Guangdong Province(Meizhou 514021)
关键词:
脊柱骨折骨折固定术;  内@后路复位固定术@椎体间植骨融合
Keywords:
Spinal fracturesFracture fixation; internal@Posterior reduction and fixation@Thoracolumbar fracture and dislocation
分类号:
R683.2
文献标志码:
A
摘要:
目的：研究胸腰椎骨折脱位的老年患者采用后路复位固定联合椎体间植骨融合治疗对患者神经功能的影响及临床效果。方法：选择126例胸腰椎骨折脱位老年患者作为研究对象，按随机数字表法分为两组各63例。对照组患者仅采用后路复位固定术治疗，观察组患者在上述基础上联合椎体间植骨融合治疗。观察两组患者手术情况、胸腰椎恢复情况以及神经功能情况。结果：两组患者术中出血量无统计学差异（P＞0.05）；观察组手术时间明显长于对照组（P＜0.05）。术前两组患者椎体高度、Cobb角以及VAS评分无统计学差异（P＞0.05）；术后观察组椎体高度、Cobb角以及VAS评分均优于对照组（P＜0.05）。术前两组患者神经功能Frankel分级无差异（P＞0.05）；术后观察组神经功能Frankel分级优于对照组（P＜0.05）。结论：后路复位固定联合椎体间植骨融合对老年胸腰椎骨折脱位患者具有较好疗效，可改善患者神经功能，有效恢复伤锥。
Abstract:
Objective：To study the effect of posterior reduction and fixation combined with interbody fusion on the neurological function of the elderly patients with thoracolumbar fracture and dislocation. Methods：According to the random number table method, two groups were divided into 63 cases. The control group was treated by posterior reduction and fixation, while the observation group was treated with interbody bone graft fusion. The operation condition, recovery of thoracolumbar vertebrae and neurological function of the two groups were observed. Results：There was no difference in bleeding volume between the two groups（P＞0.05）; the operative time in the observation group was significantly longer than that in the control group（P＜0.05）. There was no difference in vertebral height, Cobb angle and VAS score between the two groups before operation, and（P＞0.05）. The vertebral height, Cobb angle and VAS score in the observation group were better than those of the control group（P＜0.05）. There was no difference in Frankel grade of nerve function between the two groups before operation（P＞0.05）; after operation, the Frankel grading of nerve function in observation group was better than that in control group（P＜0.05）. Conclusion: posterior reduction and fixation combined with interbody interbody fusion has a good effect on the elderly patients with thoracolumbar fracture and dislocation, improving the nerve function of the patients and restoring the wound cones effectively. It is worthy of clinical application and popularization.

参考文献/References:

[1]桂凯红.后路复位固定椎体间植骨融合治疗胸腰椎骨折脱位的临床疗效及对神经功能的影响[J].临床和实验医学杂志,2014,13(10)：826-828,829.
[2]吴红.后路复位固定椎体间植骨融合治疗老年胸腰椎骨折脱位的疗效及对神经功能的影响[J].中国老年学杂志,2014,34(23):6664-6666.
[3]宋玉光,江伟,叶蜀新,等.后路复位椎间植骨融合治疗胸腰椎骨折脱位的疗效观察[J].现代中西医结合杂志,2014,23(4)：369-371.
[4]Heintel TM,Berglehner A,Meffert R.Accuracy of percutaneous pedicle screws for thoracic and lumbar spine fractures: a prospective trial[J].Eur Spine J,2013,22(3):495-502.
[5]谢阳江.后路复位固定椎体间植骨融合术治疗胸腰椎骨折脱位的疗效评价[J].中外医学研究,2015,13(14)：138-139.
[6]Kim MC,Chung HT,Cho JL,et al.Factors affecting the accurate placement of percutaneous pedicle screws during minimally invasive transforaminal lumbar interbody fusion[J].Eur Spine J,2011,20(10)：1635-1643.
[7]崔光辉.中药联合经皮椎体成形术治疗老年骨质疏松并急性胸腰椎压缩性骨折临床研究[J].陕西中医,2017,38(12)：1732-1733.
[8]滕勇,季明华,李强,等.固定角度侧块与椎弓根钉棒系统治疗无神经损伤胸腰椎骨折[J].中国骨与关节杂志,2013,2(11)：645-649.
[9]唐焕章,徐皓,董亮,等.AO-C1型胸腰椎骨折脱位：可选择4钉2棒置入单节段复位固定[J].中国组织工程研究,2015,19(22)：3525-3530.
[10]贺瑞,张文志,尚希福,等.后路经皮穿刺空心椎弓根螺钉内固定治疗胸腰椎骨折[J].临床骨科杂志,2015,18(2)：149-152.
[11]陈晓庆,陈向东,姜星杰,等.后路复位固定治疗严重胸腰椎骨折脱位[J].中华创伤骨科杂志,2015,17(3):265-267.
[12]Lau D,Terman SW,Patel R,et al.Incidence of and risk factors for superior facet violation in minimally invasive versus open pedicle screw placement during transforaminal lumbar interbody fusion: a comparative analysis[J].J Neurosurg Spine,2013,18(4):356-361.
[13]刘志.后路复位固定椎体间植骨融合治疗胸腰椎骨折脱位疗效观察[J].中国基层医药,2014,21(19)：2924-2925,2926.
[14]Gelb D,Ludwig S,Karp JE,et al.Successful treatment of thoracolumbar fractures with short-segment pedicle instrumentation[J].J Spinal Disord Tech,2010,23(5):293-301.
[15]Beck M,Mittlmeier T,Gierer P,et al.Which is the ideal point of time to perform intraoperative 3D imaging in dorsal stabilisation of thoracolumbar spine fractures? A matched pair analysis[J].Injury,2010,41(10):996-1001.

备注/Memo

备注/Memo:
*广东省梅州市科技局立项项目(2016B73)
更新日期/Last Update: 2018-11-30