文章摘要
张世磊,闫铭,丁子毅,罗卓荆.微创经皮单平面椎弓根螺钉间接减压治疗胸腰椎骨折的椎管侵占率和椎体高度观察.骨科,2020,11(6):513-517
微创经皮单平面椎弓根螺钉间接减压治疗胸腰椎骨折的椎管侵占率和椎体高度观察
Effect of indirect decompression with minimally invasive percutaneous uniplanar pedicle screw on canal encroachment rate and vertebral height in thoracolmbar fracture
投稿时间:2020-07-16  
DOI:10.3969/j.issn.1674-8573.2020.06.009
中文关键词: 胸腰椎骨折  经皮单平面螺钉  椎管侵占率  椎体高度
英文关键词: Thoracolmbar fracture  Percutaneous uniplanar pedicle screw  Canal encroachment rate  Height of vertebral body
基金项目:国家自然科学基金青年项目(81301581)
作者单位E-mail
张世磊 中国人民解放军空军军医大学第一附属医院(西京医院)骨科西安 710032  
闫铭 中国人民解放军空军军医大学第一附属医院(西京医院)骨科西安 710032  
丁子毅 中国人民解放军空军军医大学第一附属医院(西京医院)骨科西安 710032  
罗卓荆 中国人民解放军空军军医大学第一附属医院(西京医院)骨科西安 710032 zjluo@fmmu.edu.cn 
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中文摘要:
      目的 观察微创经皮单平面椎弓根螺钉间接减压治疗胸腰椎骨折的椎管侵占率和椎体高度变化。方法 回顾性分析2015年1月至2017年1月我院采用后路微创经皮单平面椎弓根螺钉间接复位治疗胸腰椎骨折的62例病人的临床资料。基于病人术前、术后1 d、术后1年的X线片和腰椎CT测量并比较手术前后的矢状位后凸Cobb角、伤椎前缘高度比及椎管内骨块占位率。结果 本组随访1.0~1.5年,平均14个月。术中无血管及神经损伤,椎体复位满意,美国脊柱损伤协会(American Spinal Injury Association, ASIA)脊髓损伤分级均恢复到E级。术后1 d、术后1年的矢状位后凸Cobb角、伤椎前缘高度比均较术前明显改善(P均<0.05),但是术后1 d与术后1年的数据比较,差异均无统计学意义(P均>0.05)。术后1 d、术后1年的椎管内骨块占位率均较术前明显降低(P均<0.05),术后1年的数值也较术后1 d时明显降低(P<0.05)。结论 经皮单平面椎弓根螺钉间接减压能够很好地恢复骨折椎体高度,有利于椎管内骨块的复位及椎管的重塑。
英文摘要:
      Objective To observe the changes of spinal canal invasion and vertebral body height in the treatment of thoracolumbar fractures with minimally invasive percutaneous single plane pedicle screw indirect decompression. Methods The clinical data of 62 patients with thoracolumbar fracture from January 2015 to January 2017 were analyzed retrospectively, and all patients were treated with posterior minimally invasive percutaneous single plane pedicle screw reduction. The sagittal kyphosis Cobb's angle, the height ratio of the anterior edge of the injured vertebra and the spinal canal occupancy rate before and after operation were measured and compared on the basis of the X-ray films and lumbar CT of the patients before, 1 day and 1 year after the operation, respectively. Results The patients were followed up for 1.0-1.5 years with an average of 14 months. There was no vascular or nerve injury during the operation, the reduction of vertebral body was satisfactory, and the neurological function of the patients recovered to grade E according to the American Spinal Injury Association (ASIA) grade. The Cobb’s angle of sagittal kyphosis and the ratio of anterior edge height of injured vertebrae were improved significantly at 1st day and 1st year after operation (P<0.05 for all), but there was no significant difference between 1st day and 1st year after operation (both P>0.05). As for the aspect of occupancy rate of spinal canal, the rate at 1st day and 1st year after operation was significantly lower than that before operation (P<0.05), and that at 1st year after operation was also significantly lower than that at 1st day after operation (both P<0.05). Conclusion Percutaneous single plane pedicle screw can not only restore the height of the fractured vertebral body well, but contribute to the restoration of bone mass in the spinal canal as well as the remodeling of the spinal canal.
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