胸腰椎骨折短段与长段固定的放射学效果比较

Ehtisham Ahmed khan Afridi, Idrees Ahmed, Sidra Maqbool, Aqsa Shahzadi, Saadia Maqbool
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摘要

目的:研究确定胸腰椎骨折短节段与长节段固定的放射学结果。材料与方法:共纳入322例(18 ~ 60岁)胸腰椎骨折患者。术前对所有患者进行x光片和CT扫描,以确定椎弓根的完整性和方向。柯布的方法也被用来估计x射线上的后凸角。所有病例均采用后路椎弓根螺钉固定。A组(N = 161)采用长节段固定,至少在骨折节段上方和下方两个节段,B组(N = 161)采用短节段固定,椎弓根螺钉放置在骨折节段上方和下方一个节段。结果:A组患者平均年龄38岁,平均骨折时间45小时;B组患者平均年龄43岁,平均骨折时间46.354小时。A组有115例(71.4%)患者有良好的放射学预后,b组有103例(64%)患者有良好的放射学预后。两组患者均观察到持续时间大于8小时的放射学预后(p值:0.049)(A: 75.5%;B: 58.1%)。结论:在骨折水平使用椎弓根螺钉进行短节段固定与长节段固定的矫正效果相当。关键词:胸腰椎骨折;短节段;长节段;
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The Radiological Outcome of Thoracolumbar Spine Fracture Fixation in Short Vs Long Segment
Objectives:  The study determined the radiological outcomes of short-segment vs. long-segment fixation of thoracolumbar spine fractures. Materials and Methods:  A total of 322 patients (18 – 60 years) with thoracolumbar spine fractures were included. Preoperative X-rays and CT scans were performed on all patients to determine the integrity and orientation of the pedicle. Cobb's approach was also used to estimate the kyphotic angle on x-rays. The posterior pedicle 65 screw fixation was used in all instances. Group A (N = 161) received long segment fixation at least two levels above and below the fractured vertebra, while Group B (N = 161) received short segment fixation with pedicle screws placed in the broken level as well as one level above and below the fractured level. Results:  In Group A, the mean age was 38 years, and the mean length of fracture was 45 hours; in Group B, the mean age was 43 years, and the mean duration of fracture was 46.354 hours. A good radiological outcome was observed in 115 (71.4%) patients in group A as compared to 103 (64%) patients in group B. A radiological outcome (p-value: 0.049) of a duration greater than 8 hours was observed in both groups (A: 75.5%; B: 58.1%). Conclusion:  Short segment fixation using a pedicle screw at the level of fracture provides comparable correction to long segment fixation. Keywords:  Thoracolumbar Fractures, Short Segment, Long Segment, Radiological Outcome.
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