Zhang Jian-Guang, Lai Bi-hua, Pan Jun-Hui, Qiu Bi-Cheng, Ye Jian
The Second Department of Orthopaedics, the First Hospital of Nanping City Afflicated to Fujian Medical University, Nanping 353001, Fujian, China.
Zhongguo Gu Shang. 2012 Dec;25(12):984-7.
To evaluate clinical effects of pedicle fixation without bone fusion in treating thoracolumbar fractures through paraspinal approach.
From January 2006 to January 2009, 25 patients (15 males and 10 females) with thoracolumbar fractures were treated. The average age was 39.3 years,ranged from 17 to 49 years. According to classification, flexion fracture in 7 cases, brust fracture in 18 cases. There were no nervous injury, and radiology information showed the angle of sagittal vertebral body >20 degrees or collapse of vertebral body >40%,without vertebral injury. The operation were performed at 3 to 7 days after injury (mean 5 day). Internal fixation implants were removed at 8 to 12 months after operation. The height, kyphosis angle were measured before operation, 1 week and 24 months after operation,and Oswestry disability index (ODI) were compared before and after operation.
All patients were followed up for 24 months. Among them, 1 case was followed up at 30 months after operation. The operation time ranged from 70 to 110 (mean 90) minutes, the blood loss was 120 to 280 (mean 200) ml. The height of vertebral body and kyphosis angle were obviously corrected, and had significant differences between postoperation immediately and at the final follow-up (P<0.05). There were no differences after remove of internal fixation (P>0.05). The final ODI was (5.36 +/- 1.21)%, had statistical differences compared with preoperation (P<0.05).
For flexion and burst thoracolumbar fractures without nervous injury, pedicle fixation without bone fusion is a good method,which has advantages of minimally invasive, rapid recovery, and maintain spinal motion segment.
评估经椎旁入路椎弓根固定不融合治疗胸腰椎骨折的临床效果。
2006年1月至2009年1月,治疗25例胸腰椎骨折患者(男15例,女10例)。平均年龄39.3岁,年龄范围17至49岁。根据分类,屈曲型骨折7例,爆裂骨折18例。无神经损伤,影像学资料显示椎体矢状面角度>20度或椎体塌陷>40%,无椎体损伤。受伤后3至7天(平均5天)行手术。术后8至12个月取出内固定植入物。分别在术前、术后1周和24个月测量椎体高度、后凸角,并比较手术前后的Oswestry功能障碍指数(ODI)。
所有患者均随访24个月。其中1例术后30个月随访。手术时间70至110(平均90)分钟,失血量120至280(平均200)ml。椎体高度和后凸角明显矫正,术后即刻与末次随访比较差异有统计学意义(P<0.05)。取出内固定后差异无统计学意义(P>0.05)。末次ODI为(5.36±1.21)%,与术前比较差异有统计学意义(P<0.05)。
对于无神经损伤的胸腰椎屈曲型和爆裂型骨折,椎弓根固定不融合是一种较好的方法,具有微创、恢复快、保留脊柱运动节段的优点。