摘要
目的 分析经皮球囊扩张椎体植骨椎弓根钉内固定治疗青壮年胸腰椎终板塌陷型压缩骨折的临床疗效。方法回顾性分析自2018-01-2021-12采用经皮球囊扩张椎体植骨椎弓根钉内固定治疗的43例青壮年胸腰椎终板塌陷型压缩骨折,比较手术前后压缩区终板高度、伤椎Cobb角、疼痛VAS评分、ODI指数。结果 本组均获得随访,随访时间平均13个月。手术时间平均155 min,术中出血量平均80 mL,术中植骨平均4.5 g。切口均一期愈合,未出现切口感染、神经损伤、内固定松动及断裂等并发症。术后压缩区终板高度较术前增加,差异有统计学意义(P<0.05),压缩区终板高度复位率为89.6%。术后6个月伤椎Cobb角较术前减小,差异有统计学意义(P<0.05)。术后1周、6个月疼痛VAS评分、ODI指数均较术前降低,差异有统计学意义(P<0.05)。结论 经皮球囊扩张椎体植骨椎弓根钉内固定治疗青壮年胸腰椎终板塌陷型压缩骨折的疗效确切,采用该手术方法治疗后伤椎高度与脊柱生物力学强度均得到满意恢复。
Objective To evaluate the clinical efficacy of percutaneous balloon expansion with bone grafting combined pedicle screw fixation for thoracolumbar endplate collapse compression fractures in young adults.Methods A retrospective analysis was performed on 43 cases of thoracolumbar end-plate collapse compression fractures in young adults treated with percutaneous balloon expansion with bone grafting combined pedicle screw fixations from January 2018 to December 2021.Endplate height,Coob angle of the injured compression vertebra area,pain VAS score,ODI score were summarized and analyzed before and one week,two months and six months after surgery.Results All patients were followed up for an average of 13 months.The aver-age operation time was 155 minutes.The average intraoperative blood loss was 80 mL.The average intraoperative bone graft was 4.5 g.The height of the endplate collapse area of the injured vertebra recovered satisfactorily after surgery.The resetting rate of endplate height in compression zone was 89.6%and the internal fixation was stable without any phenomenon of relaxation or fracture.The endplate height of the compression area of the injured vertebra increased 1 week and 6 months after surgery,while the Cob angle,pain VAS score and ODI score of the injured vertebra decreased compared with that before surgery,with statisti-cal significance(P<0.05).Conclusion Percutaneous balloon expansion with bone grafting combined pedicle screw internal fix-ation is an effective and safe method for the treatment of thoracolumbar endplate collapse compression fractures in young adults.The height of injured vertebra and spinal biomechanics can be maintained well after surgery.
作者
李新春
胡万钧
甘发荣
黄兹瑜
江晓兵
LI Xinchun;HU Wanjun;GAN Farong;HUANG Ziyu;JIANG Xiaobing(Department of Spine Surgery,Hainan Provincial Hospital of Traditional Chinese Medicine,Haikou,Hainan 570203,China)
出处
《中国骨与关节损伤杂志》
2023年第9期897-901,共5页
Chinese Journal of Bone and Joint Injury
基金
海南省临床医学中心建设项目资助([2021]276号)。
关键词
终板塌陷压缩骨折
球囊扩张
通道植骨
椎弓根钉内固定
End plate collapse compression fracture
Balloon dilatation
Channel bone grafting
Pedicle screw internal fixation
作者简介
通信作者:江晓兵,E-mail:spinedrjxb@sina.com。
