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学科主题: 骨科学
题名:
不减压非融合在手术治疗不稳定AOA型胸腰段骨折中的作用
其他题名: Non-fusion without decompression for surgical treatment of unstable AO type A thoracolumbar fractures
作者: 周方; 吕扬; 田耘; 姬洪全; 张志山; 桂琦
关键词: 脊柱骨折 ; 胸椎 ; 腰椎 ; 骨折固定术,内 ; 骨融合 ; Spinal fractures ; Thoracic vertebrae ; Lumbar vertebrae ; Fracture fixation,internal ; Bone fusion
刊名: 中华创伤杂志
发表日期: 2010
DOI: 10.3760/cma.j.issn.1001-8050.2010.05.008
卷: 26, 期:5, 页:411-414
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 探讨对于轻度神经损伤的不稳定AO A型胸腰段骨折,不进行减压及融合,单纯行短节段椎弓根螺钉固定手术的疗效. 方法对比分析我院2004年2月-2008年2月手术治疗的AO A型胸腰段骨折(T11~L2)患者42例,分为A组(未植骨组,21例),予单纯短节段椎弓根螺钉固定,而未行椎板切除减压及植骨;B组(植骨组,15例),予椎弓根螺钉固定,不进行椎板切除减压但植骨.对两组术前及术后后凸角、椎体压缩高度进行比较分析. 结果 A组术前局部后凸角平均19.1°(15.4°~29.8°),椎体压缩高度平均46%(30%~63%);术后局部后凸角5.00(0.3°~10.3°),椎体压缩高度10%(0~28%),后凸矫正率79%.平均随访21.2(12~46)个月,随访超过12个月患者21例,末次随访后凸角平均7.0°(1.8°~10.7°),椎体压缩高度10%(2%~22%).B组术前局部后凸角平均25.8°(15.9°~34.5°),椎体压缩高度平均55%(30%~76%);术后局部后凸角7.1°(1.5°~19.1°),椎体压缩高度15%(0~28%),后凸矫正率74%.平均随访17.9(12~31)个月,随访超过12个月患者15例,末次随访后凸角平均8.3°(0.7°~19.2°),椎体压缩高度15%(1%~26%),植骨全部愈合,所有患者末次随访时均无明显腰痛症状,无内固定断裂或椎弓根螺钉拔出.后凸角和椎体压缩高度两组间差异无统计学意义.结论 对于一些神经损伤较轻的AO A型胸腰段骨折,在选择椎弓根螺钉固定时,可考虑不进行椎板切除减压,也不行后外侧植骨融合. Objective To discuss the role of non-fusion without decompression in surgical treatment of unstable AO type A thoracolumbar fractures. Methods A retrospective study was performed on 42 patients with AO type A thoracolumbar fractures (T11-L2) treated with short segment pedicle screw fixation from February 2004 to February 2008. Patients were divided into two groups, ie, Croup A (treated with short segmental pedicle screw fixation without decompression or fusion) and Group B (treated with short segmental pedicle screw fixation without decompression but with fusion). The pre-operative, postoperative and follow-up local kyphotic angle, vertebrae compression rate were compared between two groups. Results In Croup A, average local kyphotic angle and average vertebrae compression rate were 19.1° (15. 4°-29. 8°) and 46% (30%-63%) respectively before operation, but 5. 0° (0. 3°-10.3°) and 10% (0-28%) respectively after operation. Twenty-one patients were followed up for average 21.2 months (12-46 months), which showed average local kyphotic angle of 7° (1.8°-10.7°) and average vertebrae compression rate of 10% (2% -22%) at final follow-up. In Croup B, average local kyphotic angle and average vertebrae compression rate were 25.8° (15.9°-34.5°) and 55% (30%-76%) respectively before operation, but 7.1° (1.5°-19. 1°) and 15% (0-28%) respectively after operation. Fifteen patients were followed up for mean 17.9 months (12-31 months) , which showed mean local kyphotic angle of 8.3° (0.7°-19.2°) and average vertebrae compression rate of 15% (l%-26%) at final follow-up. There was no pseudarthrosis, implant breakage, pedicle screw pull-out or severe back pain. There was statistical difference in local kyphotic angle and vertebrae compression rate between two groups.Conclusion Unstable AO type A thoracolumbar fractures with minor neurological deficit can be treated with pedicle screw fixation only without decompression or fusion.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/70704
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

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作者单位: 北京大学第三医院骨科,100191

Recommended Citation:
周方,吕扬,田耘,等. 不减压非融合在手术治疗不稳定AOA型胸腰段骨折中的作用[J]. 中华创伤杂志,2010,26(5):411-414.
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