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学科主题骨科学
胸腰段骨折后路椎弓根固定节段长度选择
其他题名Selection of short- or long-segment posterior fixation for treatment of unstable thoracolumbar fractures
田耘; 周方; 姬洪全; 张志山; 郭琰
关键词脊柱骨折 胸椎 腰椎 骨折固定术 骨折分型 Spinal Fractures Thoracic Vertebrae Lumbar Vertebrae Fracture Classification Fracture Fixation Internal
刊名中华创伤杂志
2010
DOI10.3760/cma.j.issn.1001-8050.2010.05.005
26期:5页:397-402
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 探讨胸腰段骨折短节段或长节段固定的选择. 方法自2005年1月-2008年12月,随访胸腰段骨折后路椎弓根固定术患者134例,骨折按照AO分型:A型70例,B型37例,C型27例.将各型骨折分为短节段固定组(伤椎上、下各1个椎体)和长节段固定组(伤椎上、下各2个椎体),比较各组在邻近椎体上下终板夹角矫正与丢失、伤椎椎体上下终板夹角矫正与丢失、C型骨折椎体移位的矫正与丢失. 结果 A型骨折全部为短节段固定,邻近椎体上下终板夹角术前平均21.3°,术后平均8.5°,术后2年平均11.1°.短节段组(26例)和长节段组(11例)B型骨折后凸角度矫正度比较差异无统计学意义.但短节段组伤椎椎体夹角丢失3.64°,长节段组丢失1.09.(P<0.05).短节段组(7例)和长节段组(20例)C型骨折后凸角度矫正度差异无统计学意义,但短节段组和长节段组矫正角度丢失分别为3.6°和0.8°(P<0.05).椎体移位矫正方面两组间差异无统计学意义.结论 A型和B1型骨折多选择短节段固定,而B2、B3及C型骨折多行长节段固定. Objective To discuss the selection of short- or long-segment posterior fixation for treatment of unstable thoracolumbar fractures. Methods A total 134 patients with thoracolumbar fractures treated with pedicle instrument fixation from January 2005 to December 2008 were studied retrospectively. According to AO fracture classification, there were 70 patients with type A fractures, 37 with type B and 27 with type C. The patients were divided into two groups according to the number of instrumented levels; short-segment posterior fixation (SSPF) group (four screws; one vertebral body above or below the fractured vertebrae) and long-segment posterior fixation (LSPF) group (eight screws; two vertebral bodies above or below the fractured vertebrae). Clinical outcomes and radiological parameters (superior-inferior endplate angle, vertebral body angle, displacement of vertebral body) were compared according to AO fracture classification. Results All type A fractures were treated with SSPF, mean superior-inferior endplate angle changed from preoperative 21.3° to postoperative 8.5° and 11.1° at final follow up. There was no statistical difference in the correction of Cobb angle for type B fractures in SSPF group (26 patients) and LSPF group (11 patients), while the correction loss of vertebral body angle was 3. 64° in SSPF group and 1.09° in LSPF group, with statistical difference (P < 0. 05). There was no statistical difference in the correction of Cobb angle for type C fractures in SSPF group (7 patients) and in LSPF group (20 patients), but the correction loss of vertebral body angle was 3.6° in SSPF group and 0. 8° in LSPF group, with statistical difference (P < 0. 05). There was no statistical difference in vertebral displacement correction. Conclusions Most types A and Bl fractures should be treated with SSPF; most types B2, B3 and C fractures should be treated with LSPF.
语种中文
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/70724
专题北京大学第三临床医学院_骨科
作者单位北京大学第三医院骨科,100191
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田耘,周方,姬洪全,等. 胸腰段骨折后路椎弓根固定节段长度选择[J]. 中华创伤杂志,2010,26(5):397-402.
APA 田耘,周方,姬洪全,张志山,&郭琰.(2010).胸腰段骨折后路椎弓根固定节段长度选择.中华创伤杂志,26(5),397-402.
MLA 田耘,et al."胸腰段骨折后路椎弓根固定节段长度选择".中华创伤杂志 26.5(2010):397-402.
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