|
|
Effect of Single- and Bilateral-Injection and Trans-Injury Nail on the Curative Effect and Prognosis of A1 Thoracolumbar Fractures |
WANG Lishan, LU Haibo, QIAN Hao |
Liaoyang Central Hospital, Liaoning Liaoyang 111000, China |
|
|
Abstract Objective: To explore the effect of single, bilateral nail and trans-nail on the efficacy and complications of type A1 thoracolumbar fracture. Methods: A total of 129 patients with A1 thoracolumbar fractures admitted from May 2019 to May 2020 were selected as the subjects who were simply randomly divided into group A, B and C, 43 cases in each. Patients in group A were treated with trans-vertebral screw placement, patients in group B with trans-vertebral screw placement on one side, patients in group C with trans-vertebral screw placement on both sides. The three groups were followed up for 1 year to compare the differences in surgical indexes, efficacy and complication. Results: During the follow-up, all patients had no serious complications such as vascular, nerve and visceral injuries during the operation. The amount of intraoperative blood loss and duration of operation in group A were lower than those in group B and C (P<0.05); walking time, full weight bearing time, hospital stay, ratio loss rate of anterior edge height and sagittal Cobb Angle loss rate of injured vertebrae were higher than those of B and C groups(P<0.05), but there was no significant difference between group B and group C (P>0.05).Repeated measures of ANOVA showed that 1 week and 1 year after surgery, Cobb Angle of sagittal position, high compression rate of anterior edge of injured vertebrae and Oswestry dysfunction score of injured vertebrae in group A were all higher than those in group B and C, and the differences were statistically significant(P>0.05). Conclusion: The treatment of injured vertebral nail in patients with A1 thoracic and lumbar fracture is better than the trans-injured vertebral nail, which can effectively prevent the late vertebral height loss and posterior protrusion deformity, and improve the prognosis of patients. Moreover, there is no obvious difference between single vertebra and bilateral nailing, which can be selected according to the patient's condition.
|
|
|
|
|
[1] Tromme A,Charles Y P,Schuller,et al.Osteoarthritis and spontaneous fusion of facet joints after percutaneous instrumentation in thoracolumbar fractures[J].European Spine Journal,2019,28(5):1~9. [2] 丛华,江峰.经椎弓根伤椎植骨置钉固定与跨伤椎椎弓根置钉固定治疗胸腰椎骨折的疗效比较[J].中国基层医药,2019,26(10):1238~1241. [3] 余红志,童贤平,朱峰.经皮椎弓根螺钉内固定与Wiltse间隙入路椎弓根螺钉内固定治疗胸腰椎骨折患者的效果比较[J].实用临床医药杂志,2020,24(13):33~36. [4] 顾军,孙小明,王俊,等.后路经肌间隙椎弓根螺钉内固定术与传统开放椎弓根螺钉内固定术治疗胸腰椎骨折脱位型损伤的临床疗效[J].河北医学,2019,25(11):1926~1929. [5] 姜泽威,汤舒婷,姚树强,等.有限脊柱截骨加椎间盘切除治疗陈旧胸腰椎骨折并后凸畸形[J].中国矫形外科杂志,2018,26(10):909~912. [6] 余斌,管四炎.经伤椎椎弓根植骨置钉后路复位内固定治疗老年胸腰椎骨折效果观察[J].浙江医学,2021,43(13):1450~1453. [7] Icardo JM,Capillo G,Lauriano ER,et al.The gas bladder of pantodon buchholzi:structure and relationships with the vertebrae[J].Morphol,2020,281(12):1588~1597. [8] 徐峰,康辉,魏坦军,等.椎弓根螺钉不同固定方法治疗胸腰椎骨折的生物力学分析[J].中国组织工程研究,2021,25(9):1313~1317. [9] 黄国平,宋锦程.经皮微创椎弓根钉棒内固定术治疗胸腰椎骨折疗效观察[J].中国伤残医学,2021,29(12):35~37. [10] 袁林,刘自明,吴振玲,等.微创经皮置钉跨伤椎固定和开放置钉附加伤椎固定治疗单节段胸腰椎骨折的临床疗效比较[J].宁夏医学杂志,2021,43(8):747~750. [11] 崔一公,王璐,曹福源,等.单向钉与万向钉在胸腰椎骨折中的应用及生物力学评价[J].中国临床研究,2019,32(5):642~646. [12] 尹永辉,金军伟,赵刚.经伤椎与跨伤椎置钉内固定治疗胸腰椎骨折的比较[J].中国骨与关节损伤杂志,2020,35(3):46~48. |
|
|
|