后路不同复位方式治疗胸腰椎爆裂骨折的临床疗效观察  

Comparative study on the effects of posterior route two surgical reduction methods for thoracolumbar burst fractures

作　　者：陈德纯[1] 时国华[1] 谭俊铭[1] 王朝阳[1] 邢顺民[1] 

机构地区：[1]解放军第98医院骨科暨全军创伤修复重建中心,浙江湖州313000

出　　处：《颈腰痛杂志》2012年第6期444-446,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨后路不同复位方式治疗胸腰椎爆裂骨折疗效比较。方法对55例AO分类为A型及部分B1、B2型的胸腰椎骨折患者临床资料进行回顾性分析:均采用后路手术,伤椎置钉;其中一组(A组)以单纯后方轴向撑开复位骨折椎体;另一组(B组)以伤椎椎弓根螺钉按撬拨、矫形原理恢复生理弧度及椎体高度,再适当撑开或不撑开,分别从伤椎前缘压缩比、侧位Cobb角、椎管面积比对比两组的治疗效果。结果 2组术前、术后椎体前缘压缩比、Cobb角及椎管面积比均有统计学意义(P<0.05),在椎体前缘压缩比和Cobb角恢复方面,B组明显优于A组,差异显著(P<0.05),并且无后方韧带复合结果过撑现象。结论伤椎置钉技术对胸腰爆裂椎骨折具有良好的即时复位效果,但通过伤椎螺钉撬拨复位优于单纯后方轴向撑开。Objective To evaluate the effects of posterior route two surgical reduction methods in the treatment of thoracolumbar burst fractures. Methods For 55 cases with injured vertebral bodies,with type A,B1 or B2 according to the AO classification were included in this study,and pediele screw were inserted in injured vertebral. One group （group A） was treated with the method of posterior distraction reduction,other group （group B） was treated with the method of poking reduction. Two groups were comparatively analyzed from three aspects. that is fractured vertebra height compression ratio,the Cobb＇s angle on sagittal plan and the area of spinal canal ratio. Resuits The ratio of the fractured vertebra anterior height compression,the Cobb＇s angle on sagittal plan and the ratio of the area of spinal canal of two groups before and after surgery had differences（P〈0.05）. The ratio of the fractured vertebra anterior height compression and the Cobb＇S angle on sagittal plan of B group were obviously better than A group （P〈0.05）,and had no overdistraction. Conclusion Vertebral pedicle screw fixation on fractured vertebrae is a safety and effective therapeutic options to treat the thoracolumbar burst fractures, and the method of poking reduction is better than distraction reduction.

关 键 词：胸腰椎 脊柱骨折 复位 

分 类 号：R683.2[医药卫生—骨科学]