Fu Song, Shao Shize, Sun Xiuchen, Hou Haitao, Liu Haijun, Wang Longqiang, Wang Huan, Huang Xiangpeng, Lü Renhua
Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
Department of Neurology, Wendeng Central Hospital of Weihai, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Oct;27(10):1221-4.
To evaluate the effectiveness of using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach to treat thoracolumbar kyphosis caused by old fracture.
Between June 2008 and June 2010, 15 cases of thoracolumbar kyphosis caused by old fracture were treated with pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach. There were 9 males and 6 females with a mean age of 54.6 years (range, 39-65 years). The disease duration was 5 months to 3 years with an average of 1.5 years. Fractured segments included T11 in 1 case, T12 in 4 cases, L1 in 5 cases, and L2 in 5 cases. Ten patients had nerve symptom, according to American Spinal Injury Association (ASIA) grading, 3 cases were classified as grade B, 4 cases as grade C, and 3 cases as grade D, of which 3 cases had sexual and sphincter dysfunction. At preoperation, the Cobb angle was (47.4 +/- 10.2) degrees; the Oswestry disability index (ODI) score was 67.9% +/- 6.9%; and the visual analogue scale (VSA) was 8.6 +/- 1.4.
The wounds obtained primary healing. The mean follow-up time was 28 months (range, 13-60 months). X-ray films showed intervertebral bone fusion was obtained within 6-11 months (mean, 10.2 months). No fixation loosening or breaking occurred during follow-up. Kyphosis was corrected, and lumbar back pain was relieved. At 1 year after operation, Cobb angle was significantly corrected to (13.3 +/- 7.7) degrees (t = 72.80, P = 0.00); ODI score was significantly improved to 25.2% +/- 4.6% (t = 48.04, P = 0.00); VAS score was significantly decreased to 2.3 +/- 0.6 (t = 26.52, P = 0.00). According to ASIA grading in 10 patients with spinal cord injury, the spinal cord function was improved by 1 grade in 8 cases (3 cases from grade B to C, 3 cases from grade C to D, and 2 cases from grade D to E); 3 patients with sexual and sphincter dysfunction recovered in different degrees.
Using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach is an effective method to treat thoracolumbar kyphosis caused by old fracture.
评估通过后路在骨折节段使用椎弓根螺钉、椎间撑开及植入椎间融合器治疗陈旧性骨折所致胸腰椎后凸畸形的有效性。
2008年6月至2010年6月，对15例陈旧性骨折所致胸腰椎后凸畸形患者采用后路在骨折节段使用椎弓根螺钉、椎间撑开及植入椎间融合器的方法进行治疗。其中男性9例，女性6例，平均年龄54.6岁（范围39 - 65岁）。病程5个月至3年，平均1.5年。骨折节段包括T11 1例、T12 4例、L1 5例、L2 5例。10例患者有神经症状，根据美国脊髓损伤协会（ASIA）分级，B级3例，C级4例，D级3例，其中3例有性功能及括约肌功能障碍。术前Cobb角为（47.4±10.2）°；Oswestry功能障碍指数（ODI）评分为67.9%±6.9%；视觉模拟评分（VSA）为8.6±1.4。
伤口均一期愈合。平均随访时间28个月（范围13 - 60个月）。X线片显示椎间骨融合在6 - 11个月内获得（平均10.2个月）。随访期间未发生内固定松动或断裂。后凸畸形得到矫正，腰背痛缓解。术后1年，Cobb角显著矫正至（13.3±7.7）°（t = 72.80，P = 0.00）；ODI评分显著改善至25.2%±4.6%（t = 48.04，P = 0.00）；VAS评分显著降至2.3±0.6（t = 26.52，P = 0.00）。10例脊髓损伤患者按ASIA分级，8例脊髓功能改善1级（3例从B级升至C级，3例从C级升至D级，2例从D级升至E级）；3例性功能及括约肌功能障碍患者不同程度恢复。
通过后路在骨折节段使用椎弓根螺钉、椎间撑开及植入椎间融合器是治疗陈旧性骨折所致胸腰椎后凸畸形的有效方法。
