后路经伤椎椎弓根钉棒系统内固定治疗胸腰段骨折.doc

后路经伤椎椎弓根钉棒系统内固定治疗胸腰段骨折 　　【摘要】 目的：探?后路经伤椎椎弓根钉棒系统内固定治疗胸腰段骨折的临床效果。方法：选择2010年6月-2015年6月采用后路经伤椎椎弓根钉棒系统内固定治疗78例胸腰段骨折患者。测量并比较患者术前、术后即时及末次随访时的伤椎Cobb角、伤椎前缘高度比（FVHR）、脊髓神经功能ASIA分级及疼痛视觉模拟评分（VAS），计算伤椎Cobb角和椎体前缘高度比（FVHR）的术后即时矫正度和末次随访时丢失度。结果：所有患者均得到6～24个月的随访，平均（15.42±3.14）个月。术前与术后即时、术后即时与末次随访之间伤椎前缘高度比（FVHR）和疼痛视觉模拟评分（VAS）比较，差异均具有统计学意义（P=0.000）；术前与术后即时之间伤椎Cobb角比较，差异具有统计学意义（P=0.000），末次随访的伤椎Cobb角比术后即时略微增加，但差异无统计学意义（P=0.052）；术后脊髓神经功能恢复可。结论：后路经伤椎椎弓根钉棒系统内固定是治疗胸腰段骨折的有效术式，能够增加伤椎内固定的稳定性和较好地预防术后椎体高度丢失、后凸畸形及内固定失效等远期并发症的产生 【关键词】 胸腰段骨折； 骨折内固定； 伤椎椎弓根置钉 doi：10.14033/ki.cfmr.2017.3.001 文献标识码 A 文章编号 1674-6805（2017）03-0001-03 【Abstract】 Objective：To investigate the clinical efficacy of posterior transpedicular internal fixation with pedicle screw and bar system at the injured level for thoracolumbar fractures.Method：A total of 78 cases of thoracolumbar spine fracture were treated by posterior transpedicular internal fixation with pedicle screw and bar system at the level of the fractured vertebra from June 2010 to June 2015.The fracture vertebra Cobb angle，the fracture vertebra height ratio（FVHR），the ASIA grading of spinal cord function and the visual analogue scale scores were measured and compared before operation，immediately after the operation and at the last follow-up visit.The postoperative immediate corrective and lost degrees at the time of the last follow-up of the fracture vertebra Cobb angle and the FVHR were calculated.Result：The 78 cases were followed up for 6 to 24 months with an average of （15.42±3.14） months.Both the FVHR and the VAS scores showed statistically significant differences whether between preoperation and immediate postoperation or between immediate postoperation and the last follow-up visit（P=0.000）.The fracture vertebra Cobb angle also had statistically significant difference between preoperation and immediately after the operation（P=0.000）.Although the Cobb angle of the last follow-up was slightly larger than that of immediately postoperation，it had no statisti