背腰椎爆裂性骨折的短节段固定与长节段固定

M. El-karamany, Ashraf Bakr, Mostafa Saad, Mohamed Shabanah
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摘要

在所有脊柱外伤中,胸椎和腰椎部位占 90% 以上。胸腰段位于较硬的胸椎和较灵活的腰椎之间,特别容易受伤。本研究的目的是预测这些固定对患者在疼痛、畸形、运动障碍和残疾方面的长期影响,并确定固定后椎体的功能稳定性。有 20 人参与了我们的研究。我们对患者进行了病史采集、身体和神经系统检查,并进行了影像学检查,如脊柱 X 射线和 CT 扫描,必要时还进行了脊柱核磁共振成像检查。我们从研究中了解到,A 组的平均年龄为 34.8 岁,B 组的平均年龄为 30.10 岁。男性受到的影响比女性严重。胸腰椎是高空坠落最常造成骨折的部位,其次是车祸(RTA)。大多数患者只有胸腰椎骨折,没有其他并发症。入院时,L1 和 L3 水平是最常见的神经系统检查结果(30%),其次是 L2 水平(50%)。(25%)。临床稳定的胸腰椎骨折患者通常在入院时出现背部不适。A 组无神经功能缺损报告,而 B 组的这一比例为 30%。A 组的柯氏角中位数为 9,范围从 4 到 18 不等,而 B 组的柯氏角中位数为 12,范围从 2 到 35 不等。约 85% 的患者在随访期间残疾程度很小。胸腰椎爆裂性骨折的长节段固定和短节段固定都是适用的、可重复的手术治疗技术,在术后疼痛康复、脊柱活动度和 cobbs 角方面都有相似可比的结果。但长节段固定可提供更高的稳定性,特别是在多层次骨折中,而对脊柱活动度的牺牲最小。
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Short vs long segment fixation of dorsolumbar burst fracture
The thoracic and lumbar areas account for over 90% of all traumatic spine injuries. The thoracolumbar region, located between the more stiff thoracic and the more flexible lumbar spines, is especially vulnerable to injury.o injury. The purpose of this research was to foresee the long-term effects of these fixations on patients in terms of pain, deformity, motor deficit, and handicap, as well as to identify the functional stability of the vertebral column following fixation. Twenty people participated in our research. Patients had their histories taken, were examined physically and neurologically, and had imaging studies such x-rays and CT scans of the spine and MRIs of the spine performed if needed. What we learn from the research is, Group A had a mean age of 34.8 while Group B had a mean age of 30.10. Males were impacted more severely than females. The thoracolumbar spine is the most often broken in falls from height, followed by car accidents (RTA). Most patients just had thoracolumbar fractures and no other concomitant injuries. On admission, L1 and L3 levels were the most prevalent neurological findings (30%), followed by L2 levels (50%). (25 percent ). Clinically stable thoracolumbar spine fractures often presented with back discomfort at first.. No neurological deficit was reported in group A compared to 30% in group B. The median cobb's angle in group A was 9, ranging from 4 to 18, while in group B, the median cob's angle was 12, ranging from 2 to 35. About 85% of patients had minimal disability during follow up. The long segment and short segment fixation of thoracolumbar burst fractures are both applicable, reproducible techniques of surgical management with similar comparable results regarding postoperative pain rehabilitation, spinal mobility and cobbs angle. But long segment fixation gives more stability specially in multilevel fractures with minimal acceptable sacrifice of spine mobility.
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