[1]王鑫鑫,李林军,刘大栋.改良椎间截骨术治疗胸腰椎陈旧性骨折后凸畸形[J].中医正骨,2019,31(06):63-66.
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改良椎间截骨术治疗胸腰椎陈旧性骨折后凸畸形()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年06期
页码:
63-66
栏目:
临床报道
出版日期:
2019-06-20

文章信息/Info

作者:
王鑫鑫李林军刘大栋
(周口市中心医院,河南 周口 466000)
关键词:
脊柱骨折 胸椎 腰椎 截骨术 脊柱后凸
摘要:
目的:观察改良椎间截骨术治疗胸腰椎陈旧性骨折后凸畸形的临床疗效及安全性。方法:2014年1月至2017年5月,采用改良椎间截骨术治疗胸腰椎陈旧性骨折后凸畸形患者20例,男5例、女15例。年龄52~68岁,中位数58岁。后凸顶椎位于T126例、L18例、L23例、L33例。所有患者后凸畸形Cobb角均大于20°,且呈渐进性加重,伴有畸形处疼痛,经大于6个月非手术治疗无效。术后随访观察截骨面骨愈合、后凸畸形矫正、腰部疼痛缓解、腰椎功能恢复及并发症发生情况。结果:本组患者手术时间(194.0±15.4)min,术中出血量(777.0±28.0)mL。所有患者均获随访,随访时间18~48个月,中位数36个月。截骨面均骨性融合。矢状面Cobb角,术前33.7°±4.6°、术后3个月5.3°±2.5°、末次随访6.1°±3.3°; 腰部疼痛视觉模拟量表评分,术前(7.1±1.3)分、术后3个月(3.1±1.6)分、末次随访(2.8±1.6)分; Oswestry功能障碍指数,术前(74.3±13.0)%、术后3个月(21.3±5.8)%、末次随访(17.3±4.1)%。1例出现一过性下肢肌力下降,给予激素和营养神经药物治疗,出院1个月后下肢肌力恢复正常; 1例出现大腿前外侧放射痛,给予激素和营养神经药物治疗,2周后症状明显缓解; 均无椎弓根钉松动、断裂及假关节形成等并发症发生。结论:采用改良椎间截骨术治疗胸腰椎陈旧性骨折后凸畸形,术中出血少,截骨面骨愈合率高,能矫正后凸畸形、缓解腰部疼痛、促进腰椎功能恢复,并发症少,值得临床推广应用。

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备注/Memo

备注/Memo:
(收稿日期:2018-11-14 本文编辑:时红磊)
更新日期/Last Update: 1900-01-01