دانلود مقاله کاهش باز شکستگی مربوط به قفسه صدری و مهره های کمری
چکیده
رزومه
مقدمه
مطالب و روش ها
روش
آمار
نتایج
بحث
نتیجه
سطح شواهد
منابع
Abstract
Resume
Introduction
Materials and methods
Procedure
Statistics
Results
Discussion
Conclusion
Level of evidence
References
چکیده
مقدمه: اصلاح شکستگی‌های ستون فقرات قفسه صدری و کمر با ابزار دقیق با استفاده از پیچ‌های شانز، روشی موثر برای تثبیت و بازیابی تعادل ساژیتال است. مواد و روش‌ها: مطالعه مشاهده‌ای دوطرفه، شامل بیمارانی است که برای مدیریت شکستگی‌های قفسه سینه و کمر تحت آرترودز با پیچ‌های شانز قرار می‌گرفتند، مشخصات کلی، نوع و محل شکستگی، علاوه بر افزایش ارتفاع مهره‌ها و زاویه سگمنتال قبل مورد بررسی قرار گرفت. بعد از جراحی. کنترل بالینی و تصویربرداری بعد از عمل و یک ماه بعد از آن انجام شد. p-value < 0.05 از نظر آماری معنی دار بود. یافته ها: از 35 بیمار تحت آرترودز، 13 بیمار به دلیل عدم وجود تصویر و پیگیری از مطالعه خارج شدند. نسبت مردان بیشتر بود، محل اصلی شکستگی و طبقه بندی ستون فقرات AO به ترتیب در T12 و نوع A4/B1 بود، عارضه حین عمل وجود نداشت، نیازی به تزریق خون نبود و بستری کوتاه مدت در بیمارستان بود. یک عارضه خفیف در پیگیری ارائه شد. میانگین تغییرات قبل و بعد از عمل 12 درجه در زاویه کاب و 5.2 میلی متر ارتفاع بدن مهره در مهره شکسته بود که این تغییرات از نظر آماری معنی دار بود. نتیجه‌گیری: اصلاح شکستگی ستون فقرات توراکولومبار و کمر با تثبیت بخش کوتاه با استفاده از پیچ‌های شانز، یک روش مؤثر، ایمن و سریع است که افزایش ارتفاع مهره‌ای و اصلاح زاویه سگمنتال را به‌طور قابل‌توجهی نشان می‌دهد و در نتیجه اصلاح تعادل و تراز ستون فقرات را نشان می‌دهد.
توجه! این متن ترجمه ماشینی بوده و توسط مترجمین ای ترجمه، ترجمه نشده است.
Abstract
Introduction
The correction of thoracic and lumbar spine fractures with a short instrumentation using Schanz screws, is an effective method for stabilization and sagittal balance restoration.
Materials and methods
Bidirectional observational study, included patients undergoing arthrodesis with Schanz screws to manage thoracic and lumbar fractures, the general characteristics, type, and location of the fracture, besides the gain in height of the vertebral body and segmental angle were analyzed before and after surgery. Clinical and imaging control was performed postoperatively and 1 month after this. p-value < .05 was statistically significant.
Results
Of 35 patients undergoing arthrodesis, 13 were excluded due to the absence of images and follow-up. There was a higher proportion of men, the main location of the fracture and AO spine classification was in T12 and type A4/B1 respectively, there was no intraoperative complication, no transfusion was required, and a short hospital stay. A mild complication was presented in the follow-up. The average pre and postoperative change was 12 degrees in the Cobb angle and 5.2 mm vertebral body height in the fractured vertebra, these changes were statistically significant.
Conclusion
Thoracolumbar and lumbar spine fracture correction with short segment fixation using Schanz screws, is an effective, safe and fast, showing significantly vertebral height gain and segmental angle correction, as a consequence, a correction of the balance and alignment of the spine.
Introduction
Spinal cord injury (SPI) is an event which leads to changes in sensory function, motor functions, normal autonomy and also may affect the physical, psychological and social wellbeing of the patient.1 Aetiologically, over 90% of SPI cases are caused by traffic accidents, violence, sports or falls and combined with the fact that the lesions of the spinal column often occur at a relatively young age, their socio-economic impact is significant.2
The locations most often affected in spinal cord trauma are: the sub axial cervical spine region (50%), followed by the thoracic region (35%) and the lumbar region (11%). Of these latter two, the thoraco-lumbar junction is affected in 50%–78% of patients who are neurologically intact.2, 3 The aim of fracture treatment is mainly to obtain and maintain a stable reduction leading to early mobilization and in the last instance, to a satisfactory attachment and function. A secondary objective is sagittal balance restoration and this has gained force during the last decade.
Results
Third five patients underwent open reduction of vertebral fracture by means of the Schanz screws from January 2016 to March 2020 in the Hospital Santa Clara, Bogotá, Colombia. Thirteen patients were excluded, since there were no postoperative images and outpatient clinical follow-up.
Analysis was performed with a total of 22 patients, where the majority were male, with an average mean age of 34 and time of onset to surgery of eight days. The levels most affected T12 and L1; within these, the most common type of fracture was B1 and A3/A4, respectively. None of the patients presented with intraoperative complications, and only one patient had a minor (seroma) complication, which was spontaneously resolved during follow-up (Table 1, Table 2). Time in surgery was between one hour and 1.5 h. No red blood cells or other type of haemoderivatives were required for transfusion either intra or postoperatively and all patients were discharge early whenever possible.