胸腰椎后外侧钉棒系统前后一体固定技术治疗胸腰椎疾病的近期疗效

Priliminary study of anteroposterior integration fixation by posterolateral nail-stick system for thoracolumbar disorders

目的:探讨自行设计的后外侧钉棒系统前后一体固定技术治疗胸腰椎疾病的临床疗效。方法:2009年12月～2010年5月期间,应用后外侧钉棒系统前后一体固定技术治疗胸腰椎椎体病变患者12例(椎体爆裂性骨折5例,陈旧性骨折3例,结核2例,肿瘤2例);其中9例伴有胸腰椎后凸畸形,术前Cobb角12°～22°,平均15.9°±3.6°;8例伴有神经功能损害。通过观察局部疼痛(VAS评分)缓解程度、脊柱后凸畸形(Cobb角)的矫正、神经功能(Frankel分级)恢复及并发症等情况对疗效进行评价。结果:本组患者全部获得平均6.8个月(4～10个月)的随访,所有患者术后局部疼痛缓解,术后VAS评分3.8±1.0分,较术前(7.8±0.9分)明显改善(P<0.01)。脊柱后凸畸形得到不同程度的矫正,术后脊柱后凸Cobb角0.9°±2.9°,与术前相比差异有统计学意义(P<0.01)。伴有神经功能损害者,末次随访时除1例神经功能无改善外,其余患者均有1级或1级以上的恢复。随访期内无内固定松动及断裂等现象。结论:胸腰椎后外侧钉棒系统前后一体固定技术治疗胸腰椎疾病可取得较好的近期临床疗效。

Objective：To explore the clinical effect of anteroposterior integration fixation（APIF） by using self-designed posterior lateral nail-stick system for thoracolumbar disorders.Method：A retrospective analysis was conducted on 12 patients with spine disorders（including 2 tumor,2 tuberculosis,5 burst fracture and 3 old fracture）,of these,9 cases were complicated with thoracolumbar kyphosis,with the mean preoperative Cobb angle of 15.9°±3.6°（range,12°-22°）,and 8 cases had neurofunction deficit.The pain status（VAS）,kypjosis correction（Cobb）,neurofunction improvement（Frankel） and complication were reviewed.Result：All cases were followed up for an average of 6.8 months（range,4-10 months）,pain relief was achieved in all cases with the postoperative VAS score decreasing to 3.8±1.0 compared with preoperative 7.8±0.9（P0.01）.The postoperative Cobb angle decreased to 0.9°±2.9°,which showed significant difference compared with preoperative ones（P0.01）.All except 1 had neurofunction improved at least 1 level.No instrument failure was noted at follow-up.Conclusion：Anteroposterior integration fixation by posterolateral nail-stick system is reliable for thoracolumbar disorders.