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椎弓根螺钉内固定联合椎体成形治疗老年新鲜胸腰椎骨折 被引量:2

Pedicle Screw Internal Fixation Combined with Percutaneous Vertebroplasty to Treat Senile Patients with Fresh Thoracolumbar Fractures
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摘要 目的探讨后路椎弓根螺钉内固定联合椎体成形治疗老年新鲜严重胸腰椎骨折的可行性及临床效果。方法观察9例患者,患者年龄61—77岁,平均年龄68.2岁,均为新鲜的、压缩超过1/2或爆裂严重的椎体骨折。所有患者均采用后路椎弓根螺钉内固定复位胸腰椎骨折,经椎弓根穿刺于骨折椎体中注入适量骨水泥治疗胸腰椎骨折。对术前、术后1周及术后3个月骨折椎体的疼痛采用疼痛视觉模拟评分(VAS)及骨折椎体的Cobb角进行对比。结果随访6~12个月,术前、术后1周及术后3个月的VAS分别为6.78、1.44、0.22,术后2~3天患者即可下床活动。术后伤椎Cobb角恢复满意,椎管容积明显改善,内固定无松动及断裂,无邻近椎体压缩性骨折等,3例脊髓神经损伤患者术后明显改善。结论后路椎弓根螺钉内固定联合椎体成形治疗老年新鲜胸腰椎骨折术后能明显减轻患者疼痛,矫正后凸畸形,能让患者早期下床活动,减少老年患者长期卧床并发症,提高老年患者的生活质量,效果明显。 Objective To investigaility the feasible and clinical effect of pedicle screw internal fixation combined with percutaneous vertebroplasty to treat senile patients with fresh thoracolumbar fractures. Methods There were 9 cases of fresh thoracolumbar fractures which compression than 1/2 or severe burst vertebral fracture and the age was 61 to 77 years old, mean 68.2 years old. All patients were treated by posterior pedicle screw fixation and reduction of thoracolumbar fracture, transpedicular puncture in the fracture vertebral body into the amount of bone cement for the treatment of thoracolumbar fractures. Vertebral fracture pain ( pain using a visual analogue scale, VAS) and vertebral fractures Cobb angle Preoperative,postoperative 1 week and postoperative 3 months were compared. Results The pe- riod follow - up was 6 - 12 months and the VAS of preoperative and postoperative 1 week and postoperative 3 month were 6.78, 1.44, 0. 22. All the patients could get out of bed to the activities after operation 2 - 3 days. After operation the fracture of vertebral kyphosis Cobb angle were recovered satisfactorily, the vertebral canal volume were improved significantly, and there were no internal fixation loose- ning and rupture and no adjacent vertebral fractures etc. There were 3 cases of spinal cord injury improved significantly after operation. Conclusion It is feasible and has obvious effect that by posterior pedicle screw internal fixation combined with percutaneous vertebroplas- ty to treat senile patients with fresh thoracolumbar fractures which can significantly reduce the pain of patients, correct kyphosis, allow early ambulation of patients, reduce the complications of long - term bed patients and improve the quality of life of elderly patients.
出处 《医学研究杂志》 2015年第8期121-125,共5页 Journal of Medical Research
关键词 椎弓根螺钉 椎体成形 老年 脊柱骨折 Pedicle screw Vertebroplasty Senile Spinal fractures
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