双切口椎弓根螺钉置入可有效恢复胸腰椎骨折后的伤椎高度

Effective restoration of the injured vertebral height due to thoracolumbar fractures implanted with double-incision pedicle screws

背景:研究表明后路椎弓根螺钉是治疗屈曲压缩型骨折的首选治疗方式。目的:观察腰椎后路双切口内固定置入恢复胸腰椎骨折后的伤锥高度及临床效果。方法:经X射线及胸腰椎MRI确诊的屈曲压缩型胸腰椎骨折患者34例,均采用腰椎后路双切口椎弓根螺钉内固定治疗。结果与结论:34例患者平均随访8.9个月,在随访期内,患者均未出现内固定物松动、断裂。疼痛疗效中,34例患者,完全缓解21例,部分缓解1例,轻微缓解1例。与治疗前相比,患者治疗后椎体高度丢失减少(P<0.01),功能独立性评测评分升高(P<0.01),疼痛目测类比评分降低(P<0.01)。结果证实,腰椎后路双切口内固定能有效恢复伤椎高度对患者肢体功能恢复及疼痛减轻方面确切有效,是胸腰段屈曲压缩型骨折患者有效的治疗方法。

BACKGROUND： Studies show that the posterior pedicle screw fixation is the preferred treatment for flexion compression fracture. OBJECTIVE： To observe the injured vertebral height and clinical effects of thoracolumbar fractures treated by the two-incision posterior fixation with pedicle screw. METHODS： Thirty-four patients with thoracolumbar flexion compression fracture diagnosed by X-ray and MRI of thoracolumbar were treated by the two-incision posterior fixation with pedicle screw. RESULTS AND CONCLUSION： Thirty-four patients were followed-up for 8.9 months in average. There was no loosening of internal fixation or fracture during the follow-up. Complete remission of 21 cases, partial remission of 1 case, and minor response of 1 case were observed in pain treatment. The loss of injured vertebral height of patients was decreased （P 0.01）, the score of the evaluation of functional independence was increased （P 0.01）, and the score of pain visual analogue was decreased （P 0.01） after treatment compared with before. The results confirm that the two-incision posterior internal fixation of the lumbar can effectively restore the injured vertebral height and limb function, and achieve pain relief. It is the effective treatment for patients with thoracolumbar flexion compression fractures.