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计算机断层扫描辅助有限减压在伴有神经功能缺损的胸腰椎骨折手术治疗中的疗效。

Efficacy of computed tomography-assisted limited decompression in the surgical management of thoracolumbar fractures with neurological deficit.

机构信息

Department of the Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou, China.

Department of the Neurosurgery, University of California San Francisco, San Francisco, CA, USA.

出版信息

J Orthop Surg Res. 2021 Apr 14;16(1):263. doi: 10.1186/s13018-021-02388-4.

Abstract

OBJECTIVE

To investigate the effect of CT-assisted limited decompression in managing single segment A3 lumbar burst fracture.

METHOD

A retrospective study (January 2015-June, 2019). One hundred six cases with single-level Magerl type A3 lumbar burst fractures treated with short-segment posterior internal fixation and limited decompression. Patients were divided into two groups: CT-assisted group and non-CT-assisted group. Perioperative factors, clinical outcomes, post-operative complications, imaging parameters, and health-related quality of life (HRQoL) were evaluated.

RESULTS

Kyphosis, loss of anterior and posterior vertebral body heights, operative time, and post-operative complications were not significantly different between the two groups. The visual analog score (VAS) and spinal canal encroachment in the CT-assisted group were lower compared with the non-CT-assisted group (p < 0.05). The Japanese Orthopaedic Association (JOA) score, the simplified HRQoL scale, and the American Spinal Injury Association (ASIA) Spinal Cord Injury Grade in the CT-assisted group were significantly higher compared with the non-CT-assisted group (p < 0.05).

CONCLUSION

CT-assisted limited decompression in the treatment of single-segment A3 lumbar burst fracture can achieve better fracture reduction and surgical results and improve the long-term recovery of the patients' neurological function and quality of life.

摘要

目的

探讨 CT 辅助下有限减压治疗单节段 A3 型腰椎爆裂骨折的效果。

方法

回顾性研究(2015 年 1 月至 2019 年 6 月)。106 例单节段 Magerl 型 A3 型腰椎爆裂骨折患者接受短节段后路内固定和有限减压治疗。患者分为 CT 辅助组和非 CT 辅助组。评估围手术期因素、临床结果、术后并发症、影像学参数和健康相关生活质量(HRQoL)。

结果

两组在后凸畸形、椎体前、后高度丢失、手术时间和术后并发症方面无显著差异。CT 辅助组的视觉模拟评分(VAS)和椎管侵占程度均低于非 CT 辅助组(p < 0.05)。CT 辅助组日本矫形协会(JOA)评分、简化 HRQoL 评分和美国脊柱损伤协会(ASIA)脊髓损伤分级均显著高于非 CT 辅助组(p < 0.05)。

结论

CT 辅助下有限减压治疗单节段 A3 型腰椎爆裂骨折可获得更好的骨折复位和手术效果,并改善患者神经功能和生活质量的长期恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc5d/8048249/1cc97adf5890/13018_2021_2388_Fig1_HTML.jpg

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