脊柱外固定器治疗胸腰椎骨折的疗效观察.docxVIP

脊柱外固定器治疗胸腰椎骨折的疗效观 吴威强R远明黄中飞彭金贵 吴威强 R远明黄中飞彭金贵 平南同安骨伤医院脊柱科广西医科大学第二附属医 院骨科广西中医药大学附属瑞康医院骨脊柱科 摘要： 目的探讨新型脊柱外固定器联合伤椎椎体成形术或伤椎植骨治疗胸腰椎骨折的 临床疗效。方法回顾分析该院2011-0720 1 6-07住院治疗221例胸腰椎骨折患者 的情况。方法是先应用脊柱外固定器进行骨折复位后分别行椎体成形术（骨质疏 松性骨折）或伤椎植骨术（外伤骨折）。依据影像学资料计算术前、术后和末次 随访伤椎高度丢失率、后lni Cobb角及视觉模拟评分（visual analogue scale, VAS）。结果221例患者在行手术治疗后及末次随访时的伤椎高度丢失率、后凸 Cobb角及视觉模拟评分均较治疗前有明显改善，差异有统计学意义（P0. 05）, 末次随防结果与治疗后各项指标对比差异无统计学意义。骨水泥渗漏13例，椎 体高度丢失11例，无并发神经损伤。无螺钉松动及螺钉断裂病例。结论应用脊 柱外I古I定器治疗胸腰椎骨折创伤小，且安全有效。 关键词： 胸腰椎;骨折;脊柱外固定; 作者简介：吴威强（1977-）,男，大学本科，学士学位，主治医师，研究方向: 脊柱外科疾病的诊治。E-mail: wqiangl63@163. com 作者简介：陈远明（1971-），男，医学博士，主任医师，研究方向：脊柱微创。 E-mail:rkyygk@163. com 收稿日期：2017-05-03 基金：广西壮族自治区教育厅高校科研项目（编号:ZD2014066） Clinical effect of spinal external f ixation instruments on treatment of thoracolumbar factures WU Wei-qiang CHEN Yuan-ming HUANG Zhong-fei Department of Spinal Surgery, Tongan Orthopedic Hospital of Pingnon County; Abstract： Objective To explore the cl inical effect of a new approach of spinal external fixation combined with vertebroplasty or vertebral bone graft on thoracolumbar fracturcs. Methods The clinical data of 221 patients with thoracolumbar fractures were collected in our hospital from July 2011 to July 2016 and were retrospectively analyzed. External fixation instruments were initially used for fracture reduction and then vertebroplasty ( for osteoporotic fracture) or vertebreil bone graft ( for traumatic fractures) was performed. The injury vertcbral heights at the time of preoperation, postoperation and the final follow-up according to the radiographic data, kyphotic Cobb Angle and visual analogue scale ( VAS) were recorded. Results Al 1 the 221 patients improved significantly after surgery and at the time of the final follow-up in injured vertebral height, kyphotic Cobb Angle and visual analogue scale ( P 0. 05) . There were no significant differences in the indicators between the postoperative resuIts and the final fellow-up resuIts. Major complications occurred in 24 cases, includi