急性脊柱创伤的综合诊断与椎弓根螺钉内固定并发症的处理

Clinical Experience in Diagnosis and Treatment of Acute Spinal Trauma and Transpedicular Internal Fixation Complication

目的分析探讨急性脊柱创伤的综合诊断及椎弓根螺钉内固定术并发症的处理,为临床诊治方案的选择提供科学依据。方法对我院2012年4月—2013年8月收治的26例急性脊柱创伤患者诊治过程进行回顾性分析,所有患者均完善相关影像学检查,并行椎弓根螺钉内固定手术治疗。结果 26例患者中,2例保守治疗,24例手术治疗,其中并发症4例。治疗后的Cobb’s角及椎体前缘压缩高度与治疗前比较差异显著;术后随访1年,2例保守治疗患者、24例手术治疗患者,包括其中的4例并发症患者,均已康复,无截瘫及其他严重的神经损伤。结论急性脊柱损伤诊断离不开X线、CT和MRI,三者互有优缺点,将其有效结合能显著提高诊断准确率,而椎弓根螺钉内固定手术疗效确切,安全可靠,特别是椎弓根螺钉内固定术并发症的科学处理,保证了手术效果,值得临床推广。

OBJECTIVE To analyze the diagnosis and treatment of acute spinal trauma and transpedicular internal fixation complication,providing scientific basis for clinical options. METHODS The treatment process of 26 cases of acute spinal trauma patients collected from April 2012 to August 2013 were retrospectively analyzed. All patients were given related imaging survey, and pediculus arcus vertebrae screw internal fixation operation was processed. RESULTS The Cobb＇s angle and the anterior vertebral compression height of injured spinal column turned better. During the one-year follow-up, no paraplegia or other severe neurologic damage complications appeared, and only 1 case of pediculus arcus vertebrae screw loosening happened, improving after symptomatic treatment.CONCLUSIONS The diagnosis of acute spinal injury could not do without X-ray, CT and MRI. Those three have their own advantages and disadvantages, and effective combination could lead to significantly improved diagnosis. The pediculus arcus vertebrae screw internal fixation operation is accurately effective, safe and reliable, which is worthy of wide clinical application.