CT测量胸腰椎椎弓根相关参数在胸腰椎骨折患者手术治疗中的应用

Application of Thoracolumbar Vertebral Pedicle Related Parameters Measured by CT in Surgical Treatment of Patients with Thoracolumbar Fractures

目的采用CT测量胸腰椎椎弓根相关参数,并探究其在胸腰椎骨折患者手术治疗中的应用。方法选取2018年1月至2019年3月来我院进行椎弓根螺钉内固定术治疗的胸腰椎骨折患者94例,术前采用CT检测胸腰椎骨折患者的胸腰椎椎弓根相关参数,根据CT结果设计置钉方案,探究CT检测对置钉效果的影响,并比较患者手术前、后的椎体高度压缩度及椎管面积、脊柱后凸程度、神经功能,术后随访1年,观察患者不良事情发生情况。结果94例患者置钉后优91例,良2例,中1例,差0例,失误率3.19%。患者术后的椎体高度压缩度及椎管面积均较术前增大(P<0.05),脊柱后凸程度较术前减小(P<0.05);患者术后的神经功能分级较术前有明显改善(P<0.05)。术后随访1年,无1例断钉、螺钉松动、神经损伤等不良情况发生。结论术前采用CT测量胸腰椎椎弓根相关参数有助于确认螺钉置入位置,其置入精确度高、效果好,促进患者伤椎恢复,降低了并发症的发生。

Objective To measure thoracolumbar vertebral pedicle related parameters by CT,and explore its application in the surgical treatment of patients with thoracolumbar fractures.Methods A total of 94 patients with thoracolumbar fractures who underwent pedicle screw internal fixation in the hospital from January 2018 to March 2019 were enrolled.Before surgery,thoracolumbar vertebral pedicle related parameters were measured by CT.The screws placement plans were designed based on CT results.The influences of CT test on screws placement effect were explored.The compression of vertebral height,spinal canal area,kyphosis and nerve function before and after surgery were compared.They were followed up for 1 year after surgery.The occurrence of adverse events was observed.Results Of the 94 patients after screws placement,there were 91 cases with excellent status,2 cases with good status,1 case with moderate status and 0 case with poor status.The error rate was 3.19%.After surgery,compression of vertebral height and spinal canal area were increased(P<0.05),while kyphosis was alleviated(P<0.05).After surgery,nerve function grading was significantly improved(P<0.05).After 1 year of postoperative follow-up,there was no any one case with broken screw,screw looseness or nerve damage.Conclusion The preoperative measurement of thoracolumbar vertebral pedicle related parameters by CT is beneficial to confirm the sites of screws placement,with high placement accuracy and good effects.It can promote the recovery of injured vertebra and reduce the incidence of complications.