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韧带整复术对高麦科马克分级的胸腰椎爆裂骨折临床及影像学结果的影响

The Effect of Ligamentotaxis on Clinical and Radiological Outcomes in Thoracolumbar Burst Fractures with High McCormack Grade.

作者信息

Secer Mehmet, Gurbuz Hande, Gulcu Anil

机构信息

Department of Neurosurgery, Alaaddin Keykubat University School of Medicine, Antalya, Turkey.

Department of Anaesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.

出版信息

J Coll Physicians Surg Pak. 2023 Mar;33(3):355-357. doi: 10.29271/jcpsp.2023.03.355.

Abstract

The aim of this study was to investigate the effect of ligamentotaxis performed in combination with the posterior surgical approach in thoracic and lumbar burst fractures due to high-energy trauma with high McCormack scores (≥7). This observational study was conducted at the University of Health Sciences from January 2015 to December 2020. Medical records of 16 patients were retrospectively evaluated. The vertebral height measurements, local kyphosis angles, and anteroposterior spinal canal diameter were measured pre- and postoperatively. American Spinal Injury Association (ASIA), McCormack, and thoracolumbar injury classification and severity (TLICS) scores were also evaluated. All postoperative measurements showed a significant change. There was no statistical significance in the pre- and postoperative ASIA grades. No screw breakages were observed within a mean follow-up period of 35.50±11.79 months. Ligamentotaxis effectively increased the spinal canal diameter and provided vertebral height restoration and kyphosis angle correction in thoracolumbar burst fractures with a high McCormack score. However, no significant neurological improvement was observed in cases with neurological deficits, although laminectomy was performed with ligamentotaxis. Key Words: Ligamentotaxis, Lumbar vertebrae, Spine, Thoracic vertebrae, Thoracolumbar burst fractures, Trauma.

摘要

本研究的目的是探讨在高能量创伤导致的胸腰椎爆裂骨折且麦科马克评分较高(≥7分)时,联合后路手术进行韧带整复的效果。这项观察性研究于2015年1月至2020年12月在健康科学大学开展。对16例患者的病历进行了回顾性评估。在术前和术后测量椎体高度、局部后凸角和椎管前后径。还评估了美国脊髓损伤协会(ASIA)、麦科马克和胸腰椎损伤分类及严重程度(TLICS)评分。所有术后测量结果均显示有显著变化。术前和术后的ASIA分级无统计学意义。在平均35.50±11.79个月的随访期内未观察到螺钉断裂。韧带整复有效地增加了椎管直径,并在麦科马克评分较高的胸腰椎爆裂骨折中实现了椎体高度恢复和后凸角矫正。然而,尽管在韧带整复的同时进行了椎板切除术,但在有神经功能缺损的病例中未观察到明显的神经功能改善。关键词:韧带整复;腰椎;脊柱;胸椎;胸腰椎爆裂骨折;创伤

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