胸腰椎爆裂骨折患者经皮椎弓根钉内固定治疗中椎管内脊髓造影的应用效果

Application Effect of Intraspinal Myelography in the Treatment of Thoracolumbar Burst Fracture Patients by Percutaneous Pedicle Screw Internal Fixation

目的分析胸腰椎爆裂骨折患者经皮椎弓根钉内固定治疗中椎管内脊髓造影的应用效果。方法选取驻马店魏道德骨科医院2015年3月-2017年1月收治的78例胸腰椎爆裂骨折患者为研究对象,所有患者均行经皮长U形空心椎弓根钉内固定术,术中骨折复位效果经椎管内脊髓造影评价,并对其进行分析。结果手术时间平均为(90.15±2.59)min,术中出血量平均(60.12±2.58)mL;术中共行88次造影,造影结果显示,造影液正常流通的患者共有68例,造影液流通延迟的患者共有8例,造影液流通受到阻碍的患者共有2例;患者术前患者矢状位后凸Cobb角为(15.7±5.2)°,伤椎前缘高度比值为(63.6±6.2)%,术后2d分别矫正到(4.24±1.12)°、(92.8±3.4)%,没有出现伤椎高度与后凸Cobb角矫正度丢失现象。结论胸腰椎爆裂骨折患者行经皮椎弓根钉内固定术中采用椎管内脊髓造影利于对骨折复位情况进行有效评估,及早将脊髓压迫与骨折复位不良情况发现,进而及时行单侧开窗减压干预。

Objective To analysis the application effect of intraspinal myelography in the treatment of thoracolumbar burst fracture patients by percutaneous pedicle screw internal fixation.Methods A total of 78 patients with thoracolumbar burst fractures admitted to weidaode orthopedics hospital in zhumadian from March 2015 to January 2017 were selected as the study objects.All patients underwent percutaneous long u-shaped hollow pedicle screw internal fixation,and the reduction effect of intraoperative fracture was evaluated by intraspinal myelography and analyzed.Results The average operation time was(90.15±2.59)min,and the average intraoperative blood loss was(60.12±2.58)ml.A total of 88 angiograms were performed,and the results showed that there were 68 patients with normal flow of contrast medium,8 patients with delayed flow of contrast medium and 2 patients with obstructed flow of contrast medium.The Cobb angle of sagittal kyphosis was(15.7±5.2)before operation,and the ratio of the anterior height of the injured vertebra was(63.6±6.2)%,which were corrected to(4.24±1.12)and(92.8±3.4)%respectively,two days after operation.There were no loss of correction of kyphosis Cobb Angle and the injured vertebra height.Conclusion The intraspinal myelography performed in the treatment of percutaneous pedicle screw fixation for the thoracolumbar burst fractures is conducive to effective evaluation of fracture reduction,early detection of spinal cord compression and poor fracture reduction,and timely unilateral window decompression intervention.