資源描述:
《經(jīng)后路器械固定間接減壓與開(kāi)放減壓》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫(kù)。
1、維普資訊http://www.cqvip.com·536·中華創(chuàng)傷骨科雜志2006年6月第8卷第6期ChinJOrthopTrauma,June:!::.臨床論著·經(jīng)后路器械固定間接減壓與開(kāi)放減壓治療胸腰椎骨折療效比較分析王朝陽(yáng)袁文陳華江王新偉顧滔湯俊君【摘要】目的比較分析胸腰椎骨折在后路器械固定下對(duì)椎管間接減壓虧開(kāi)放減壓兩種方式的臨床療效。方法回顧性分析2001年1月~2004年l2月收治的76例胸腰椎骨折患者,將其分為兩組:42例行后路暴露、椎弓根螺釘系統(tǒng)復(fù)位內(nèi)固定術(shù),將其定義為間接減壓組;34例
2、行半椎板或全椎板減壓,椎弓根螺釘內(nèi)固定,半椎板、橫突或關(guān)節(jié)突融合術(shù),定義為開(kāi)放減壓組。觀察兩組的術(shù)中情況及并發(fā)癥,評(píng)價(jià)各組的脊柱矯形、椎管占位、復(fù)位及神經(jīng)功能恢復(fù)情況,各組觀察指標(biāo)進(jìn)行統(tǒng)計(jì)學(xué)比較分析。結(jié)果間接減壓組的平均手術(shù)時(shí)間、術(shù)中出血量及術(shù)后引流量分別為65min、150mL和70mL,而開(kāi)放減壓組為110min、360mL和145mL,兩組間差異有顯著性意義(P<0.05)。椎體前高、后高、Cobb角隨訪時(shí)的丟失率及丟失角度兩組分別為:間接減壓組為2.3%、1.2%和0.5。,開(kāi)放減壓組為7.7
3、%、2.6%和3.1。,兩組間差異無(wú)顯著性意義(P>0.05)。間接減壓組術(shù)后椎管平均減壓30.2%,開(kāi)放減壓組32.2%。兩組術(shù)后Franke1分級(jí)均有1~2級(jí)改善。結(jié)論間接減壓組較開(kāi)放減壓組具有手術(shù)時(shí)間短、術(shù)中出血少、術(shù)后引流量少、脊柱矯正度丟失率低、術(shù)后康復(fù)快、脊柱穩(wěn)定性好及無(wú)明顯并發(fā)癥的優(yōu)點(diǎn),兩組在椎管減壓程度及神經(jīng)功能恢復(fù)進(jìn)步方面效果相近。【關(guān)鍵詞】胸椎;腰椎;骨折;減壓Indirectdecompressionversusopendecompres~ontovertebralcanalin
4、treatmentofthoracolumbarfractureswithposteriorpedicleinstrumentfixationWANGChao—yn凡g,YUANWen,CHENHua-jiang,etⅡ£DepartmentofOrthopaedics,ChangzhengHospital,TheSecondMilitaryMedicalUniversity,Shanghai200003,China[Abstract10bjectiveToevaluatetheclinicaleff
5、ectsofindirectdecompressionandopendecompressiontovertebralcanalintreatmentofthoracolumbarfractureswithposteriorpedicleinstrumentfixation.MethodsSev—enty—sixeasesofthoraeolumbarfracturewhoweretreatedinourhospitalfromJanuary2001toDecember2004.Theyweretwog
6、roups:intheindirectdecompressiongroup,42casesunderwentposteriorexposition,reductionandfix·ationwithpediclescrews;intheopendecompressiongroup,34easesweretreatedwithposteriorhemi·laminectomyorfull—laminectomy,internalfixationwithpediclescrewsandfusionofhe
7、mi.1aminaortransverseprocessorarticularprocess.Theperioperativedataandcomplicationsinthetwogroupswereanalyzed.Thereshapingofvertebralcol·umn,volumeofvertebralcanal,andFrankelgradingwereevaluated.Thedatawerecomparedstatistically.Re.suitsThemeanoperationt
8、ime,perioperativebleeding,postoperativedrainagewere65min,150mL,and70mLrespectivelyintheindirectdecompressiongroup,andl10min,360mL,and145mLintheopencompressiongroup.Intheformergroup,thelosingratesofanteriorandposteriorheightsofver