腰椎骨折后路短节段固定术后矫正丢失及相关因素的影像学分析

目的:分析腰椎骨折后路短节段固定术后矫正丢失情况并分析影像学相关因素.方法:对2015年1月至2018年12月行后路短节段固定的48例腰椎骨折患者的影像学资料进行回顾性分析,其中男32例,女16例;年龄23～60(45.98±8.20)岁;骨折节段为L2-L4.测量术前、术后1周、末次随访时伤椎前缘高度(anterio...

Imageology study of correlation loss and its related factors after short-segment pedicle screw reduction and fixation for lumbar fractures

Objective: To analyze the correction loss after posterior segmental fixation for lumbar spine fractures and explore the related image factors.Methods: Posterior short-segment fixation was received in 48 patients with L₂-L₄ fractures. There were 32 males and 16 females,with ages of 23 to 60 (45.98±8.20) yeaes. The anterior vertebrae height (AVH),vertebral wedge angle (VWA) of the injured vertebra and local kyphosis angle (LKA) were measured before operation,1 week after operation and the final follow-up. The loss of segmental discal angle (LoSDA),LKA(LoLKA),AVH(LoAVH) were calculated between 1 week postoperative and the last follow-up. Preoperative load-sharing scores(LSS),TLICS scores,and adjacent intervertebral disc injuries(IDIs) were assessed. Then the correlation between the age,follow-up time,LSS,TLICS,IDIs and the correction loss was analyzed.Results: The average follow-up was 12 to 18(16.13±5.39) months. LKA,AVH and VWA at 1 week postoperative and those at the final follow-up,were significantly improved compared with those preoperative(P<0.05). In the final follow-up,the average LKA(5.70±3.17)° and AVH(4.31±5.95)% correction loss were observed compared with those 1 week postoperative(P<0.05). Otherwise the lose of VWA was not obvious(P>0.05). Univariate analysis showed that the SDA(r=0.706,0.579,0.449) and LKA(r=0.715,0.566,0.502) correction loss were aggravated with the increase of LSS,TLICS and IDIs,and AVH(r=-0.325,-0.219) correction loss was aggravated with the increase of LSS and TLICS(P<0.05). Multivariate analysis showed that increased LSS scores were all risk factors for segmental disc angle (SDA) loss,LKA correction loss,and AVH correction loss(P<0.05).Conclusion: The angle of adjacent intervertebral discs and anterior height of injured vertebrae were lost statistically after posterior short-segment pedicle screw treatment for lumbar fractures,and multivariate analysis showed that all of them were correlated with load-sharing score.