短节段椎弓根钉内固定治疗非相邻型多节段脊柱骨折的临床研究  

The effects of short-segment pedicle screw fixation for treating non-adjacent multi-segmental spinal fractures

作　　者：张吉红[1] 王晓娟[1] 党红胜[1] 吴五洲[1] 王波[1] 崔操[1] 邹海兵[2] 

机构地区：[1]湖北医药学院附属太和医院骨科五病区,湖北十堰442000 [2]湖北医药学院,湖北十堰442000

出　　处：《西部医学》2017年第1期106-109,共4页Medical Journal of West China

基　　金：湖北省科技厅项目(2013CFC031)

摘　　要：目的探讨短节段椎弓根钉内固定治疗非相邻型多节段脊柱骨折的效果。方法非相邻型多节段脊柱骨折患者108例根据随机数字表法分为治疗组与对照组各54例,对照组给予后路长节段椎弓根钉内固定治疗;治疗组给予短节段椎弓根钉内固定治疗。结果治疗后,治疗组在出血量和手术时间,明显低于对照组(P<0.05);治疗组并发症发生率明显低于对照组(P<0.05)。两组术后的伤椎前缘高度比值明显增加,而Cobb角明显减少,与术前对比均有明显差异(P<0.05),但治疗组的伤椎前缘高度与Cobb角单优于照组,差异在统计学上均有意义(P<0.05)。两组术后神经功能均较术前有一定程度的恢复(P<0.05),临床治疗效果上,治疗组明显优于对照组(P<0.05)。两组术前JOA评分无明显差异,术后JOA评分治疗组明显高于对照组(P<0.05)。结论短节段椎弓根钉内固定治疗非相邻型多节段脊柱骨折临床效果明显且具有更加微创安全的特点,还可促进神经功能与腰椎功能的恢复。Objective To investigate the effects of short-segment pedicle screw fixation for treating non-adjacent multi-segmental spinal fractures. Methods 108 patients with non-adjacent multi-segmental spinal fractures based on randomly were equally divided into the treatment group and the control group. The control group were given long-segment posterior pedicle screw fixation. The treatment group was given short segmental pedicle screw fixation. Results All patients were completed the treatment. The operative time and blood loss in the treatment group were significantly less than that of the control group （P^0.05）. The postoperative infection, back pain, cerebrospinal fluid leakage and other complications in the treatment group were significantly less than that in the control group （P〈0.05）. The postoperative leading edge vertebral height ratio was significantly increased. Cobb angle was significantly reduced （P〈0.05）. The postoperative leading eading edge vertebral height ratio and Cobb angle in the treatment group were significant differences from that of the control group （P〈0.05）. The postoperative neurological function were improved significantly in the two groups（P〈0.05）. The postoperative neurological function in the treatment group were significantly better than the control group （P〈0.05）. The preoperative JOA scores was no significant difference between the two group （P〈0.05）. The postoperative JOA score in the treatment group was significantly higher in that of the group （P〈0.05）. Conclusion The short segment pedicle screw fixation for the non-adjacent multi-segmental spinal fractures has more invasive security features, which can promote functions and lumbar functional recovery and help vertebral recovery.

关 键 词：短节段椎弓根钉内固定 非相邻型多节段脊柱骨折 并发症 神经功能 

分 类 号：R683.2[医药卫生—骨科学]