胸腰椎骨折患者后路融合内固定术后矫正角度丢失的危险因素分析
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摘要
目的分析胸腰椎骨折患者后路融合内固定术后矫正角度丢失的危险因素。方法回顾性分析2013年1月至2016年1月我院收治的125例胸腰椎骨折患者的临床资料。分析后路融合内固定术后矫正角度丢失的危险因素,并提出治疗建议。结果本研究中,20例(16.00%)患者术后发生矫正角度丢失。发生组术中未植骨、椎体内蛋壳样改变、损伤水平椎间盘高度丢失、术后负重锻炼开始时间<6个月的占比高于未发生组(P<0.05);多因素Logistic分析显示,术中植骨、椎体内蛋壳样改变、损伤水平椎间盘高度丢失及术后负重锻炼开始时间均为胸腰椎骨折患者后路融合内固定术后矫正角度丢失的独立危险因素(P<0.05)。结论对胸腰椎骨折患者行后路融合内固定术后,其矫正角度丢失风险较大,临床应探讨合理的预防措施,以防止其矫正角度的丢失。
Objective To analysis of risk factors for loss of correction angle after posterior fusion internal fixation in patients with thoracolumbar fracture. Methods The clinical data of 125 patients with thoracolumbar fractures admitted in our hospital from January 2013 to January 2016 were retrospectively analyzed. The risk factors of angle loss after posterior fusion and internal fixation were analyzed, and treatment suggestions were put forward. Results In this study, 20 cases(16.00%) suffered from loss of corrective angle after operation. The proportions of non-bone graft, egg shell-like changes in vertebral body, loss of intervertebral disc height at injury level and starting time of weight-bearing exercise less than 6months after operation in the occurrence group were higher than those in the non-occurrence group(P <0.05). The multivariate Logistic analysis showed that intraoperative bone grafting, eggshell-like changes in the vertebral body, loss of intervertebral disc height at the level of injury and start time of weight-bearing exercise after operation were independent risk factors for loss of corrective angle in patients with thoracolumbar fracture after posterior fusion and internal fixation(P <0.05). Conclusion After posterior fusion internal fixation for thoracolumbar fracture patients, the risk of loss of correction angle is high. Clinical prevention measures should be explored to prevent loss of correction angle.
Objective To analysis of risk factors for loss of correction angle after posterior fusion internal fixation in patients with thoracolumbar fracture. Methods The clinical data of 125 patients with thoracolumbar fractures admitted in our hospital from January 2013 to January 2016 were retrospectively analyzed. The risk factors of angle loss after posterior fusion and internal fixation were analyzed, and treatment suggestions were put forward. Results In this study, 20 cases(16.00%) suffered from loss of corrective angle after operation. The proportions of non-bone graft, egg shell-like changes in vertebral body, loss of intervertebral disc height at injury level and starting time of weight-bearing exercise less than 6months after operation in the occurrence group were higher than those in the non-occurrence group(P <0.05). The multivariate Logistic analysis showed that intraoperative bone grafting, eggshell-like changes in the vertebral body, loss of intervertebral disc height at the level of injury and start time of weight-bearing exercise after operation were independent risk factors for loss of corrective angle in patients with thoracolumbar fracture after posterior fusion and internal fixation(P <0.05). Conclusion After posterior fusion internal fixation for thoracolumbar fracture patients, the risk of loss of correction angle is high. Clinical prevention measures should be explored to prevent loss of correction angle.
引文
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[3]汪涛,潘选平,唐先红.胸腰椎骨折经后路椎弓根螺钉内固定松动断裂的原因分析[J].贵州医药,2016,40(3):292-293.
[4]王翔,蔡毅,郑明辉,等.胸腰椎骨折脱位经后路长节段内固定术后力线不良及其原因分析[J].中国临床解剖学杂志,2017,35(1):85-89.
[5]陈教想,王向阳,徐华梓,等.颈前路内固定融合治疗外伤性下颈椎损伤术后邻近节段矢状面角度丢失的相关因素分析[J].中国脊柱脊髓杂志,2016,26(2):131-138.
[6]徐海栋,史新瑞,刘刚,等.胸腰椎骨折伤椎置钉临床疗效评估及椎体前缘高度丢失原因分析[J].临床与病理杂志,2016,36(1):32-37.