后路钉棒系统内固定治疗胸腰椎骨折临床疗效剖析.docVIP

后路钉棒系统内固定治疗胸腰椎骨折临床疗效剖析 　　[摘要] 目的 探讨后路钉棒系统内固定在治疗胸腰椎骨折方面的临床价值。 方法 将我院骨伤科自2011年7月～2014年5月间收治的41例胸腰椎骨折患者作为观察对象，对其实施后路钉棒系统内固定治疗，部分患者联合外侧植骨治疗，观察患者治疗前后椎体前后缘高度、Cobb角及脊髓功能变化情况。 结果 手术均获得成功，按照JOA评分标准，手术优良率达87.8%，其椎体前后缘高度及脊髓功能较治疗前明显改善，差异比较有统计学意义（P0.05）。 结论 后路钉棒系统内固定治疗胸腰椎骨折临床效果显著，可使受伤椎体复位，维持椎体的稳定性，同时具有手术时间短、操作简单、固定性好的优点，值得推广。 　　[关键词] 后路钉棒系统内固定；胸腰椎骨折；疗效 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2015）08-0056-03 　　[Abstract] Objective To explore the effect of posterior screw rod in treatment of thoracolumbar fractures. Methods A total of 41 patients with thoracolumbar fractures were as the observation objects who were treated by bone traumatology department in our hospital from July 2011 to May 2014. All patients were treated by posterior screw rod， and some patients were treated with bone graft. The fanterior trailing edge height， Cobb angle and the change of the spinal cord function were observed before and after treatment. Results All surgical were successful， and fine rate was 87.8% according to JOA scoring criteria. Fanterior trailing edge height and spinal cord function improved significantly than those before treatment（P0.05）. Conclusion The posterior screw rod has a good clinical effect in the treatment of thoracolumbar fractures，and it can restore the injured vertebral body and maintain the stability of the vertebral body， which also has a shorter operation time， simple operation and good fixity of advantages， and it is worth promoting. 　　[Key words] Posterior screw rod system internal fixation； Thoracolumbar fractures； Effect 　　随着当前经济的迅猛发展，交通意外、高处坠落等意外伤害的事故率明显上升，往往导致胸腰椎骨折脱位，而此类创伤常会伴有脊柱正常解剖结构及稳定性遭到损伤，继而引发脊髓、神经受损[1]。目前，临床上常运用后路钉棒系统内固定治疗胸腰椎骨折，后路钉棒内固定相对于前路内固定而言，具有较为明显的力学优势。而我院自2011年开展此项技术，获得良好疗效，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　41例患者均是我院骨伤科自2011年7月～2014年5月收治的患者，其中男27例，女14例，年龄21～64岁，平均（41.6±4.7）岁，其中摔伤32例，车祸伤9例，胸椎多节段骨折7例，单节段椎体骨折34例；损伤最低平面为L4，最高平面为T7，包括胸椎骨折13例，腰椎26例，胸腰椎骨折2例；按照Denis分类：爆炸型9例，安全带型13例，压缩型7例，骨折脱位型12例；脊髓损伤分类按照ASIA标准：A级4例，B级11例，C级16例，D级10例，E级0例。合并其他损伤：四肢骨折者6例，