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经皮椎弓根螺钉治疗胸腰椎骨折:长期随访

Percutaneous Pedicle Screw for Thoracolumbar Fractures: A Long-term Follow-up.

作者信息

Furtado Marcos Vinícius da Rocha, Braga Gabriel Santos, Rossanez Roberto, Herrero Carlos Fernando Pereira da Silva

机构信息

Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Mar 21;59(1):e101-e106. doi: 10.1055/s-0044-1779701. eCollection 2024 Feb.

Abstract

This is a retrospective cohort study to analyze the long-term outcomes of thoracolumbar spine fracture patients who underwent minimally invasive percutaneous fixation.  The cases of 17 patients with thoracolumbar spine fractures who had percutaneous fixation between 2009 and 2011 were the subject of a retrospective analysis. Clinical and radiographic variables were collected. For the clinical evaluation the questionnaires SF-36 and Oswestry were used. Radiographic parameters were evaluated using fracture's classification based on Magerls's criteria, the fractured vertebra's wedging angle, and the affected segment's segmental Cobb angle. The measures were made at different stages: before surgery, immediately after surgery, one year later, and at a late follow-up (5 years later). Trauma associated injuries, post-surgical and implant related complications were among the additional information taken into account.  The SF-36 questionnaire showed averages above 63,5% in all domains in the late postoperative data (from 5 years after the surgery). Oswestry questionnaire answers showed minimal or no physical limitations in 80% of the patients with a mean score of 10,8%±10,5. The average preoperative Cobb angle value was 5,53° ± 13,80° of kyphosis, the immediate postoperative 2,18° ± 13,38° of kyphosis, one year postoperative 5,26 ± 13,95° of kyphosis, and the late follow-up 8,78° ± 15,06° of kyphosis. The mean correction was 3,35°, and mean loss of correction was 6,6°. There were no complications observed, no case of neurological deficit, infection or implant failure occurred.  Thoracolumbar vertebrae fractures can be surgically treated with positive late clinical and radiological outcomes and low complication rates using a minimally invasive percutaneous method.

摘要

这是一项回顾性队列研究,旨在分析接受微创经皮固定术的胸腰椎骨折患者的长期预后。对2009年至2011年间接受经皮固定术的17例胸腰椎骨折患者的病例进行回顾性分析。收集临床和影像学变量。临床评估使用SF-36问卷和Oswestry问卷。影像学参数根据Magerls标准对骨折进行分类、骨折椎体的楔角以及受累节段的节段性Cobb角进行评估。测量在不同阶段进行:术前、术后即刻、术后一年以及晚期随访(术后5年)。还考虑了创伤相关损伤、手术及植入物相关并发症等其他信息。SF-36问卷显示,术后晚期数据(术后5年起)所有领域的平均值均高于63.5%。Oswestry问卷答案显示,80%的患者身体限制极小或无身体限制,平均得分为10.8%±10.5。术前Cobb角平均后凸值为5.53°±13.80°,术后即刻为2.18°±13.38°,术后一年为5.26°±13.95°,晚期随访为8.78°±15.06°。平均矫正度为3.35°,平均矫正丢失度为6.6°。未观察到并发症,未发生神经功能缺损、感染或植入物失败病例。胸腰椎骨折采用微创经皮方法手术治疗,临床和影像学晚期预后良好,并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/994f/10957267/700dd94bf82e/10-1055-s-0044-1779701-i2300159pt-4.jpg

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