术前可视化技术引导下椎弓根螺钉内固定对多节段腰椎骨折脱位的治疗分析

摘要

Objective To analyze the clinical effect of pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique. Methods A total of 21 patients with multi-segmental lumbar fracture and dislocation were selected from November 2012 to November 2013. Before the screw implantation, the structure of bilateral pedicle was observed through Mimics software and the implantation parameters were measured. The position of pedicle screws by postoperative CT scan, operation time, and the satisfaction of the patients were assessed. The percentages of anterior vertebral height and Cobb′s angle were measured before operation, 2 weeks and 8 months after operation. Results All patients were satisfied with informed consent score and the way of pedicle screw and the selection of plant were more reasonable. With better screw position, shorter operative time and less blood loss and adverse reactions, pedicle screw fixation achieved good effect. Conclusion With high security and considerable clinical value, pedicle screw fixation in the treatment of multi-segmental lumbar fracture and dislocation under the guidance of visualization technique has exact and good effecct.%目的：对可视化技术引导下椎弓根螺钉内固定对多节段腰椎骨折脱位的治疗效果进行分析探讨。方法：选择2012年11月至2013年11月间我院收治的多节段腰椎骨折脱位患者21例，使用Mimics软件于置钉前对椎弓根的完整性进行观察，对置钉之前、置钉之后2周以及8个月时患者伤椎的前缘椎体高度比值以及Cobb′s角进行测量，并对手术后患者骨折的复位状况和随访期内固定失败以及复位丢失的发生情况进行了解。结果：21例患者行过可视化技术引导下的椎弓根螺钉内固定，100％的患者对于知情同意的评分是非常满意；置钉方式和内植物的选择更加合理；螺钉位置、手术时间和患者失血量得到改善；椎弓根螺钉的置钉效果更佳；不良反应较少。结论：可视化技术引导下椎弓根螺钉内固定对多节段腰椎骨折脱位的效果确切，安全性高，可临床推广。