胸腰椎骨折椎弓根螺钉固定术中术后复位差异的分析

Comparison of Fracture Vertebra Recovery between Two Radiographic Films in the Treatment of Thoracolumbar Fractures with Pedicle Screw Device

目的 :提高椎弓根螺钉系统对胸腰椎骨折椎体的复位效果。方法 :2 4例胸腰椎骨折患者全麻后过伸俯卧位 ,行椎弓根螺钉系统复位固定并摄片 (术中片 ) ,术后仰卧位摄片 (术后片 )。对“术中片”、“术后片”及入院诊断时的“术前片”病椎椎体的后高、前高和Cobb’s角变化进行比较。结果 :术前、术中和术后椎体前高压缩比分别 4 3.4± 15 .3、95 .6± 6 .8和 90 .8± 8.0 ,椎体后高压缩比分别为 85 .0± 17.3、98.1± 8.5和 95 .2± 9.7,Cobb’s角分别为 2 0 .7± 6 .8、6 .0 8± 1.8和 5 .72± 2 .9。经统计学处理组间各项指标有显著差异。结论 :由于椎弓根螺钉系统存在一定弹性 ,脊柱前中柱机械力学缺陷和过伸仰卧位产生的重力 ,使术后椎体前高和Cobb’s角与术中透视相比有一定程度的丢失 ,因此 。

Objective: To improve the result of instrumental reduction in the treatment of thoracolumbar fractures with pedicle screw devices. Methods: Under general anesthesia postural reduction in stretching prone position was performed and reduction and fixation of pedicle screw devices were conducted. Radiographic films were taken after reduction and fixation in stretching prone position and in supine position, and a comparison was made between the two films and the fracture film according to the change of the height of the anterior and posterior range, the angle of kyphosis. Results: It showed that in three films, the correction rates of kyphosis was 20.7+6.8、6.08+1.8,5.72+2.9, respectively; that of anterior margin were 43.4+15.3、95.6+6.8,90.8+8.0,respectively; and posterior margin 85.0+17.3、98.1+8.5、95.2+9.7,respectively. There were significant differences in three group (P<0.01). Conclusion:Elastic property of pedicle screw devices, gravitational force produced in stretching prone position and mechanical angles, comparing between in stretching prone position and supine position. Excessive correcting might be gain satisfied recovery of fracture vertebras.