胸腰椎骨折中椎间盘损伤对经皮椎弓根螺钉内固定术后疗效的影响

Influence of intervertebral disc injury on surgical outcome of thoracolumbar fractures after percutaneous pedicle screw fixation

  • 摘要: 目的 探究胸腰椎骨折中椎间盘损伤对经皮椎弓根螺钉内固定术临床疗效的影响。方法 分析2015年1月-2018年5月收入我科的43例行后路经皮椎弓根螺钉内固定的胸腰椎骨折患者。根据Sander椎间盘损伤分型,将患者分为椎间盘损伤组(n=24)和未损伤组(n=19),分析两组患者术前术后Cobb角(Cobb angle,CA)、椎体角(vertebral body angle,VBA)和椎间角(intervertebral angle,IVA)的差异。结果 两组性别、年龄及骨折节段分布差异无统计学意义(P均>0.05)。术后两组CA、VBA及IVA均得到了显著的矫正(Ptime<0.05),但在末次随访时均出现矫正的丢失。两组间CA、VBA在各个时间点均无统计学差异(Pintergroup>0.05),但损伤组CA的矫正丢失显著高于未损伤组(4.63°±4.29° vs 2.53°±1.93°,P=0.040)。IVA在术前、术后1 d两组差异无统计学意义(P>0.05),而末次随访值1.00(0.00,1.00)° vs 0.00(-1.00,1.00)°及矫正丢失值2.50(1.00,3.75)° vs 0.00(0.00,1.00)°损伤组显著高于未损伤组(P均<0.05)。结论 胸腰椎骨折合并椎间盘损伤患者在经皮椎弓根螺钉内固定术后往往会发生更为严重的矫正丢失。

     

    Abstract: Objective To analyze the influence of intervertebral disc injuries on the surgical outcome of percutaneous pedicle screw fixation for thoracolumbar fractures. Methods Clinical data about 43 patients with thoracolumbar fractures who underwent percutaneous pedicle screw fixation in our department from January 2015 to May 2018 were retrospectively analyzed.According to the Sander's classification,the patients were divided into disc injury group (n=24) and non-injury group (n=19).The Cobb angle (CA),vertebral body angle (VBA) and intervertebral angle (IVA) were calculated and compared between the two groups before and after surgery. Results There was no significant difference in terms of gender,age,vertebral segment involved between the two groups (all P>0.05).Statistically significant improvements were observed in CA,VBA and IVA after surgery (Ptime<0.05) in both the two groups,but no significant difference was found in these radiologic outcomes between the two groups (Pintergroup>0.05),except IVA at last visit (1.000.00,1.00° vs 0.00-1.00,1.00°,P=0.012).Correction loss was found in CA,VBA,and IVA in both groups,and injury group had significant higher loss in CA (4.63±4.29° vs 2.53±1.93°) and IVA (2.501.00,3.75° vs 0.000.00,1.00°)(P<0.05,respectively). Conclusion Intervertebral disc injury may cause more serious correction loss in patients with thoracolumbar fractures after percutaneous pedicle screw fixation.

     

/

返回文章
返回