[1]安文博,张亚维,李生杰,等.短节段经皮椎弓根螺钉固定联合自固化磷酸钙人工骨植骨治疗胸腰椎单椎体骨折35例疗效观察[J].甘肃中医药大学学报,2020,37(01):85-88.[doi:10.16446/j.cnki.1001-1994.2020.01.019]
 AN Wenbo,ZHANG Yawei,LI Shengjie,et al.Curative effect observation on 35 cases of short-segment percutaneous pedicle screw fixation combined with calcium phosphate cement artificial bone grafting to treat thoracolumbar single vertebra fracture[J].Journal of Gansu University of Chinese Medicine,2020,37(01):85-88.[doi:10.16446/j.cnki.1001-1994.2020.01.019]
点击复制

短节段经皮椎弓根螺钉固定联合自固化磷酸钙人工骨植骨治疗胸腰椎单椎体骨折35例疗效观察
分享到:

《甘肃中医药大学学报》[ISSN:1003-8450/CN:62-1062/R]

卷:
37卷
期数:
2020年01期
页码:
85-88
栏目:
临床研究与报道
出版日期:
2020-02-25

文章信息/Info

Title:
Curative effect observation on 35 cases of short-segment percutaneous pedicle screw fixation combined with calcium phosphate cement artificial bone grafting to treat thoracolumbar single vertebra fracture
作者:
安文博 张亚维 李生杰 贾汝栋
甘肃省中医院白银分院骨二科, 甘肃 白银 730900
Author(s):
AN Wenbo ZHANG Yawei LI Shengjie JIA Rudong
The Second Department of Orthopedics, Baiyin Branch Hospital of Gansu Provincial Traditional Chinese Medicine Hospital, Baiyin, Gansu, 730900, China
关键词:
胸腰椎单椎体骨折经皮椎弓根螺钉自固化磷酸钙人工骨视觉模拟评分法评分椎体高度压缩率Cobb角疗效观察
Keywords:
thoracolumbar single vertebra fracturepercutaneous pedicle screwcalcium phosphate cement(CPC) artificial bonevisual analogue scale(VAS) scoreheight compression rate of vertebral bodyCobb anglecurative effect observation
分类号:
R683.2
DOI:
10.16446/j.cnki.1001-1994.2020.01.019
摘要:
目的 观察短节段经皮椎弓根螺钉固定联合自固化磷酸钙人工骨植骨治疗无神经损伤的胸腰椎单椎体骨折的临床疗效。方法 选取无神经损伤的胸腰椎单椎体骨折(Load-sharing评分≤6分)患者35例,通过短节段经皮椎弓根螺钉固定及在伤椎内经椎弓根注入自固化磷酸钙人工骨治疗。记录患者的手术时间、术中出血量,术后随访6个月,比较术前、术后1周、末次随访时患者的视觉模拟评分法(VAS)评分,矢状面Cobb角,椎体前、后缘高度压缩率。结果 35例患者均获得随访,手术时间80~100 min,平均(92.4±5.8) min;术中出血量80~95 mL,平均(88.3±6.4) mL。与术前比较,术后1周及末次随访时患者VAS评分,椎体前、后缘高度压缩率均明显降低,Cobb角明显缩小,差异均有统计学意义(P < 0.05)。结论 采用短节段经皮椎弓根螺钉固定联合自固化磷酸钙人工骨植骨治疗无神经损伤的胸腰椎单椎体骨折临床疗效显著,能明显减轻患者疼痛,降低椎体高度压缩率,增加椎体稳定性,且可减少术中出血量,值得临床推广应用。
Abstract:
Objective To observe the clinical efficacy on short-segment percutaneous pedicle screw fixation combined with calcium phosphate cement(CPC) artificial bone grafting to treat thoracolumbar single vertebra fracture without nerve damage.Methods Thirty-five cases of thoracolumbar single vertebral fracture without nerve damage(Load-sharing score≤6) were chosen,and they were treated by short-segment percutaneous pedicle screw fixation combined with transpedicular injection of CPC artificial bone into injured vertebra. The operation time and intraoperative blood loss were recorded. The patients were followed up for 6 months. The visual analogue scale(VAS) score,Cobb angle of sagittal plane,the height compression rate of anterior and posterior border of vertebral body were compared before operation,1 week after operation and the last follow-up.Results All 35 patients were followed up,the operation time was 80 to 100 min,with an average of (92.4±5.8) min;the intraoperative blood loss was 80 to 95 mL,with an average of (88.3±6.4) mL. Compared with those before operation,VAS score,the height compression rate of anterior and posterior border of vertebral body all significantly decreased,Cobb angle significantly reduced in the patients of 1 week after operation and of the last follow-up,and the difference was statistically significant(P<0.05).Conclusion It has marked clinical curative effects,can markedly alleviate the pains of the patients,decrease the height compression rate of anterior and posterior border of vertebral body and increase the stabi- lity of the vertebral body,along with reducing the intraoperative blood loss to use short-segment percutaneous pedicle screw fixation combined with CPC artificial bone grafting to treat thoracolumbar single vertebra fracture without nerve damage,which deserves clinical promotion and application.

参考文献/References:

[1] 张君.经皮椎弓根螺钉内固定术治疗胸腰椎骨折的临床疗效观察[J].中国矫形外科杂志,2017,25(2):187-189.
[2] 张思胜,赵红卫,刘扬,等.经皮椎弓根螺钉内固定并伤椎植骨成形治疗胸腰椎骨折[J].实用医学杂志,2011,27(4):648-650.
[3] Mathews H H,Long B H.Endoscopy assisten percutaneous anterior interboty fusion with subcutaneous suprafascial internal fixation,evolution for technique and surgical consi- deration[J].Orthop Int Ed,1995,3:496-503.
[4] 池永龙,徐龙梓,林焱,等.微创经皮椎弓根螺钉内固定治疗胸腰椎骨折的初步探讨[J].中华外科杂志,2004,42(21):1307-1311.
[5] 黄其杉,池永龙,王向阳,等.经皮与开放椎弓根螺钉固定治疗胸腰椎骨折的比较研究[J].中华外科杂志,2008,46(2):113-114.
[6] 顾勇杰,赵刘军,于亮,等.后路短节段伤椎经皮椎弓根螺钉内固定治疗A3型和A4型胸腰段骨折[J].中国脊柱脊髓杂志,2016,26(5):395-400.
[7] 唐康,张文志,段丽群,等.微创经皮椎弓根螺钉联合伤椎置钉治疗胸腰段脊椎骨折[J].临床骨科杂志,2014,17(3):253-257.
[8] 徐峰,蔡贤华,陈庄洪,等.经皮椎弓根螺钉固定联合伤椎可注射人工骨充填治疗胸腰椎骨折23例[J].生物骨科材料与临床研究,2011,8(5):38-40.
[9] 谢清华,陈忠羡,付兆宗,等.经伤椎椎弓根螺钉固定联合经伤椎椎弓根植骨治疗胸腰椎骨折的效果观察[J]. 中国当代医药,2017,24(28):107-110.
[10] 胡生庭,丁真奇,康两期,等.经伤椎固定及植骨治疗胸腰椎Magerl A3型骨折[J].中国脊柱脊髓杂志,2010,20(3):219-223.
[11] 齐志远,陈秀民,王在斌,等.伤椎置钉与伤椎置钉结合植骨治疗胸腰椎压缩性骨折的比较[J].临床骨科杂志,2015,18(6):641-644.
[12] 史航,朱裕成,马军,等.微创经皮椎弓根钉内固定联合伤椎椎体植骨治疗胸腰椎骨折的疗效分析[J].中国骨与关节损伤杂志,2016,31(5):513-514.
[13] 张福恒,陈德喜,郎继孝,等.聚甲基丙烯酸甲酯与磷酸钙骨水泥在骨质疏松性胸腰椎压缩骨折中的临床疗效分析[J].中国骨与关节损伤杂志,2015,30(1):21-23.
[14] 曾忠友,金才益,陆金荣,等.椎弓根螺钉系统加自固化磷酸钙人工骨灌注治疗胸腰椎骨折[J].中华创伤杂志,2001(5):27-29.
[15] 罗绮雯.自固化磷酸钙骨水泥椎体强化治疗骨质疏松椎体骨折分析[J].中国现代药物应用,2015,9(19):62-63.
[16] 施俊武,胡艇,池永龙,等.胸腰椎骨质疏松性骨折自固化磷酸钙骨水泥椎体成形的实验研究[J].中国修复重建外科杂志,2006(11):1080-1082.

备注/Memo

备注/Memo:
收稿日期:2019-01-05。
作者简介:安文博(1986-),男,主治医师,医学硕士。研究方向:脊柱外科。
通信作者:张亚维(1968-),男,副主任医师,医学学士。研究方向:脊柱外科。E-mail:2112331059@qq.com
更新日期/Last Update: 1900-01-01