| 张彦军.经后路伤椎置钉结合功能锻炼治疗胸腰椎骨折临床观察[J].实用中西医结合临床,2016,16(4): |
| 经后路伤椎置钉结合功能锻炼治疗胸腰椎骨折临床观察 |
| A Clinical Observation of evaluation of pedicle screws applied in the affected vertebra with functional exercise for the treatment of thoracolumbar fractureZHANG Yanjun1,2 ZHAO Jirong1, DENG Qiang1 LI Zhongfeng1 |
| 投稿时间：2016-03-06 修订日期：2016-03-06 |
| DOI： |
| 中文关键词: 胸腰椎骨折 伤椎椎弓根置钉 术后功能锻炼 |
| 英文关键词: thoracolumbar fractures transpedicular screw postoperative functional exercise |
| 基金项目:甘肃卫生行业计划项目，编号：GSWST2011-18 |
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| 中文摘要: |
| [目的] 探讨经伤椎椎弓根钉内固定结合术后功能锻炼治疗胸腰椎骨折的方法及效果。[方法] 短节段经伤椎治疗胸腰椎骨折患者78例,72例获得随访,术后对伤椎前缘高度、伤椎Cobb角、椎管容积、腰背痛及神经功能恢复等方面进行评价。[结果] 获得随访的患者,术后伤椎前缘高度恢复至(95.2±3.5)％,脊柱Cobb角恢复至术后的(4.5±3.2)°,伤椎平均正中矢状径恢复至术后的(96.5±2.3)％,手术前后有显著性差异(P<0.05)。患者腰背痛症状明显缓解,VAS评分由术前的(9.4±0.6)分降到术后的(2.4±2.7)分。神经功能除术前4例A级的患者下肢感觉、运动无改善,剩下患者神经功能均有1~3级的恢复；术后随访出现一例患者椎弓根螺钉断裂现象。[结论] 经伤椎椎弓根钉内固定术对骨折复位满意,重建脊柱的稳定性,术后功能锻炼对腰背痛及术后神经功能恢复起到促进作用,减少术后并发症。 |
| 英文摘要: |
| ObjectiveTo investigate curative effect for thoracolumbar fractures by the method of vertebral pedicle screw fixation applied in the affected vertebra,combined with postoperative functional exercise method and effect for the treatment of thoracolumbar fractures. Method Short segmental injury in the treatment of thoracolumbar vertebra fracture patients 78 cases, 72 cases received follow-up.After surgery and at follow-up,these patients were evaluated with X-ray and CT for anterior heights of injured vertebra and Cobb’s angle, the spine canal middle diameter, the fusion of the grafted bone and neurofunctional recovery of the spinal cord.Result Postoperative follow-up 6 ~ 36 months, the average (18±6) months, to the recovery of anterior heights of injured vertebra (95.2 ±3.5) %, Cobb’s angle back to surgery of the spine (4.5± 3.2) °, injured vertebral postoperative recovery to the spine canal middle diameter (96.5 ±2.3) %.There were significant differences before and after operation (P < 0.05).Patients with umbago and backache symptoms relief, VAS score by preoperative (9.4±0.6) to (2.4±2.7) after the operation. Neurofunctional recovery of the spinal cord except for 4 cases of preoperative neurologic function Grade A in patients with lower limb feel no improvement, sports, and the rest are 1 ~ 3 neural function in patients with recovery.Postoperative follow-up in patients with pedicle screw fracture phenomenon. Conclusion Vertebral pedicle screw fixation with postoperative function exercise can not only reduce vertebral fracture satisfactorily,increasing the stability of spine,but also postoperative function exercise of the relief of umbago and backache symptoms and neurofunctional recovery of the spinal cord, reduce the postoperative complications . |
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