后路减压椎弓根螺钉内固定治疗胸腰椎骨折疗效分析  

Clinical Analysis of Posterior Decompression and Pedicle Screw Fixation in the Treatment of Thoracolumbar Fractures

作　　者：柴臻 苏鸿利 王福平[1] 李宏伟[1] 任龙龙[1] 

机构地区：[1]榆林市第二医院骨二科,陕西榆林719000 [2]延安大学附属医院麻醉科,陕西延安716000

出　　处：《现代生物医学进展》2016年第31期6094-6096,6113,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨后路减压椎弓根螺钉内固定治疗胸腰椎骨折的疗效。方法:本研究选取了90例胸腰椎骨折患者,按照入院时间顺序不同分为两组,前路组(46例)采取前路减压椎弓根螺钉内固定治疗,后路组(44例)采取后路减压椎弓根螺钉内固定治疗。观察并记录两组患者围手术期参数,术前术后下腰痛功能、神经功能恢复情况及随访12个月期间并发症发生情况,评价后路减压椎弓根螺钉内固定治疗胸腰椎骨折的疗效。结果:后路组在术中失血量、手术时间、住院时间上均明显少于或短于前路组(P<0.05);与术前相比,术后两组Oswestry功能障碍指数(ODI)值均明显降低(P<0.05)。与术后同时间前路组相比,后路组ODI值均明显低于前路组(P<0.05);与术前相比,术后12个月两组神经功能分级整体有所提高(P<0.05),但两组间相比,差异没有统计学意义(P>0.05);随访12个月期间,两组并发症发生率比较,差异没有统计学意义(P>0.05)。结论:采用后路椎弓根螺钉内固定治疗胸腰椎骨折,手术时间短,疗效显著,术中出血量少,预后较好,有利于患者腰椎功能的恢复。Objective： To discuss the clinical efficacy of posterior decompression and pedicle screw fixation in the treatment of thoracolumbar fractures. Methods： 90 patients diagnosed thoracolumbar fractures were selected, and they were divided into two groups according to the sequence of admission time. The anterior group（46 cases） was given anterior decompression and pedicle screw fixation.The posterior group（44 cases） was adopted posterior decompression and pedicle screw fixation. The efficacy of anterior and posterior decompression and pedicle screw fixation in the treatment of thoracolumbar fractures was evaluated and compared by perioperative parameters, low back pain, recovery of neurological function and complications during 12 months follow-up. Results： The bleeding volume,surgery time, hospitalization time in anterior group were apparently less than that of the posterior group（P〈0.05）. Compared with the value before surgery, the（Oswestry Disability Index, ODI） value were apparently decreased in two groups after surgery（P〈0.05）. After 6months and 12 months surgery, the ODI value in the posterior group were apparently lower than that of the anterior group（P〈0.05）. Compared with the value before surgery, the whole neurological function were increased after 12 months of surgery（P〈0.05）, but there was no statistical significance on the whole neurological function between two groups（P〉0.05）. During 12 months follow-up there were no statistical significance on the complications between two groups（P〉0.05）. Conclusions： The posterior decompression and pedicle screw fixation has good curative effect on thoracolumbar fractures with short surgery time, little bleeding volume during surgery and good prognosis, and it was benefit to the recovery of patients with lumbar function.

关 键 词：胸腰椎骨折 椎弓根螺钉 并发症 神经功能 腰痛 

分 类 号：R683[医药卫生—骨科学]