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首页> 外文OA文献 >Treatment of Thoracolumbar Spinal Fracture Accompanied by Diffuse Idiopathic Skeletal Hyperostosis Using Transdiscal Screws for Diffuse Idiopathic Skeletal Hyperostosis: Preliminary Results
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Treatment of Thoracolumbar Spinal Fracture Accompanied by Diffuse Idiopathic Skeletal Hyperostosis Using Transdiscal Screws for Diffuse Idiopathic Skeletal Hyperostosis: Preliminary Results

机译：使用转段螺钉进行弥漫性发育性骨骼过度症的延伸性发育性骨骼过度症的治疗伴有弥漫性发育性骨骼过度症的治疗方法：初步结果

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Study Design This retrospective case series enrolled 13 patients who underwent posterior fixation with both transdiscal screws for diffuse idiopathic skeletal hyperostosis (TSDs) and pedicle screws (PSs) to treat spinal injury accompanied by diffuse idiopathic skeletal hyperostosis (DISH). Purpose To describe the usefulness, feasibility, and biomechanics of TSD. Overview of Literature Vertebral bodies accompanied by DISH generally have lower bone mineral density than normal vertebral bodies because of the stress shielding effect. This phenomenon tends to makes screw fixation challenging. To our knowledge, solutions for this issue have not previously been reported. Methods Patients were assessed using the data on surgical time, estimated intraoperative blood loss, mean number of stabilized intervertebral segments, number of screws used, perioperative complications, union rate, and the three-level EuroQol five-dimensional questionnaire (EQ5D-3L) score at the final follow-up. The Hounsfield unit (HU) values of the screw trajectory area, and the actual intraoperative screw insertion torque of TSDs and PSs were also analyzed and compared. Results The surgical time and estimated intraoperative blood loss were 165.9±45.5 minutes and 71.0±53.4 mL, respectively. The mean number of stabilized intervertebral segments was 4.6±1.0. The number of screws used was 4.9±1.3 for TSDs and 3.0±1.4 for PSs. One death occurred after surgery. The union rate and EQ5D-3L scores were 100% and 0.608±0.128, respectively. The HU value and actual intraoperative screw insertion torque of TSDs were significantly better than those of PSs (p<0.001, p=0.033). Conclusions We were able to achieve stable surgical outcomes using the combination of TSDs and PSs. The HU value and actual intraoperative screw insertion torque were significantly higher for TSDs than for PSs. Based on these results, when treating thoracolumbar spinal fractures accompanied by DISH in elderly populations, the TSD could be a stronger anchor than the PS.
机译：研究设计这一回顾性案例系列注册了13名患者接受后固定的差异螺钉，用于弥漫性发育性骨骼过度源（TSD）和椎弓根螺钉（PSS），以治疗脊柱损伤伴随着弥漫性发育性骨骼过度血症（盘）。目的来描述TSD的有用性，可行性和生物力学。由于应力屏蔽效果，由盘伴随的文学椎体概述通常具有比普通椎体更低的骨矿物密度。这种现象倾向于使螺钉固定挑战。据我们所知，此前尚未报告此问题的解决方案。方法使用关于手术时间的数据评估患者，估计术中失血，稳定椎间段的平均数，使用的螺钉数，围手术期并发症，联合率和三级欧元五维问卷（EQ5D-3L）得分在最后的后续行动。还分析了螺杆轨迹区域的Hounsfield单元（HU）值，以及TSD和PSS的实际术中螺杆插入扭矩。结果外科时间和估计的术中失血分别为165.9±45.5分钟和71.0±53.4ml。稳定的椎间段的平均数量为4.6±1.0。用于TSD的螺钉数为4.9±1.3，PSS为3.0±1.4。手术后发生一次死亡。联盟率和EQ5D-3L分别分别为100％和0.608±0.128。 TSD的HU值和实际术中螺杆插入扭矩明显优于PSS（P <0.001，P = 0.033）。结论我们能够使用TSD和PSS的组合来实现稳定的手术结果。对于PSS而言，HU值和实际的术中螺杆插入扭矩明显高于PSS。基于这些结果，当治疗由老年人群体伴随的鼻子脊柱骨折时，TSD可以是比PS更强的锚。

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