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后路减压内固定术在胸腰椎骨折合并脊髓损伤急诊治疗中的疗效

Effectiveness of Posterior Decompression and Internal Fixation in Emergency Management of Thoracolumbar Fractures Complicated by Spinal Cord Injury.

作者信息

Li Jian, Zhou Tao, Lin Sen, Wang Hongliang

机构信息

Department of Orthopedics, Ma'anshan People's Hospital, Ma'anshan 243000, China.

出版信息

Emerg Med Int. 2024 Dec 19;2024:7832479. doi: 10.1155/emmi/7832479. eCollection 2024.

Abstract

This study evaluates the effectiveness and timeliness of posterior decompression and internal fixation in the emergency management of thoracolumbar fractures complicated by spinal cord injuries. We retrospectively analyzed 40 patients treated at our hospital from January 2019 to February 2022. Each patient underwent posterior decompression and internal fixation, with preoperative and postoperative assessments including vertebral body height, American Spinal Injury Association (ASIA) score, Visual Analog Scale (VAS) score, and urodynamic indices. Postoperative improvements were noted in vertebral body height, with anterior and posterior heights increasing to 12.82 (± 1.23) mm and 3.21 (± 0.64) mm, respectively, and kyphosis angle improving to 14.26 (± 0.32). Significant enhancements were also observed in motor (from 40.78 [± 4.32] to 59.86 [± 1.37]) and sensory (from 45.98 [± 3.20] to 66.92 [± 1.28]) function scores, and a reduction in VAS score from 6.89 (± 0.78) to 1.78 (± 0.32). Urodynamic measurements showed increased maximum urine flow and detrusor pressure postintervention. All surgical wounds healed within two weeks without significant complications. Posterior decompression and internal fixation significantly improve spinal stability, pain, motor, and sensory functions in patients with thoracolumbar fractures and spinal cord injuries, demonstrating its effectiveness and clinical utility.

摘要

本研究评估了后路减压内固定术在胸腰椎骨折合并脊髓损伤急诊治疗中的有效性和及时性。我们回顾性分析了2019年1月至2022年2月在我院接受治疗的40例患者。每位患者均接受了后路减压内固定术,术前和术后评估包括椎体高度、美国脊髓损伤协会(ASIA)评分、视觉模拟量表(VAS)评分和尿动力学指标。术后椎体高度有所改善,前、后高度分别增加至12.82(±1.23)mm和3.21(±0.64)mm,后凸角改善至14.26(±0.32)。运动(从40.78[±4.32]提高到59.86[±1.37])和感觉(从45.98[±3.20]提高到66.92[±1.28])功能评分也有显著提高,VAS评分从6.89(±0.78)降低到1.78(±0.32)。尿动力学测量显示干预后最大尿流率和逼尿肌压力增加。所有手术伤口均在两周内愈合,无明显并发症。后路减压内固定术可显著改善胸腰椎骨折合并脊髓损伤患者的脊柱稳定性、疼痛、运动和感觉功能,证明了其有效性和临床实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4999/11671663/1dcd36634c62/EMI2024-7832479.001.jpg

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