经伤椎单节段与跨伤椎短节段固定治疗胸腰段骨折的疗效比较  

The effects comparison of vertebra single segment and across the injured vertebra short segment fixation for the treatment of thoracolumbar fractures

作　　者：田学涛[1] 黄吉利[1] 

机构地区：[1]江汉大学附属武汉市第六医院骨外科,湖北武汉430015

出　　处：《临床骨科杂志》2017年第4期406-409,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较经伤椎单节段固定与跨伤椎短节段固定治疗胸腰段骨折的早期临床疗效。方法对46例Dennis B型胸腰椎骨折患者分别采用经伤椎单节段固定(观察组,23例)与跨伤椎短节段固定(对照组,23例)治疗。比较两组术中出血量、手术时间及住院费用,术后定期摄X片复查,测量Cobb角及伤椎前缘高度。结果患者均获得随访,时间6~36个月。观察组术中出血量、手术时间及住院费用均明显低于对照组,差异有统计学意义(P<0.01)。术后及末次随访两组Cobb角及伤椎前缘高度比较差异均无统计学意义(P>0.05)。结论经伤椎单节段与跨伤椎短节段固定均可有效恢复脊柱序列,但经伤椎单节段固定术具有廉价、微创的优点,可作为Dennis B型胸腰段骨折首选术式。Objective To compare the clinical effects between the injured vertebra single segment and across the in-jured vertebra short segment fixation for the treatment of Dennis type B thoracolumbar fractures. Methods The 46 patients with Dennis type B thoracolumbar fracture were treated with the injured vertebra single segment fixation （ ob-servation group, 23 patients） and across the injured vertebra fixation of short segment （control group, 23 patients）, bleeding volume, operation time and the cost of hospitalization were compared, postoperative patients were observed Cobb angles and injuried verterbral anterior height by radiologic outcomes. Results The followed-up time ranged from 6 months to 36 months. The volume of intraoperative bleeding, operation time and hospitalization expenses of ob-servation group was significantly lower than control group,the difference was statistically significant（P 〈0. 01 ） . The postoperation and last follow-up of Cobb angles and injuried verterbral anterior height had no significant differences in the two groups （ P 〉 0. 05 ） . Conclusions The vertebral single segment and across the injured vertebra short seg-ment fixation can effectively restore the spinal column sequence, but the advantages of the injured vertebra fixation is cheap, minimally invasive, and has little effect on the adjacent segment disc degeneration, Dennis type B thoraco-lumbar fractures can be used as the preferred type of operation.

关 键 词：胸腰椎骨折 单节段固定 短节段固定 

分 类 号：R683.2[医药卫生—骨科学] R687.32[医药卫生—外科学]