胸腰段椎体骨折复位效果相关因素分析  

Factors related to reduction quality of thoracolumbar fractures

作　　者：刘华[1] 肖辉[1] 朱长宝 王建元[1] 李海峰[1] 高源泽 董晖[1] 

机构地区：[1]中国人民解放军第474医院,新疆乌鲁木齐830012

出　　处：《中国矫形外科杂志》2017年第18期1637-1641,共5页Orthopedic Journal of China

摘　　要：[目的]探讨影响胸腰段椎体骨折复位效果的相关因素。[方法]通过回顾性分析本院2012年1月~2015年12月收治的148例胸腰段椎体单节段骨折并行手术治疗患者的相关资料,分析胸腰段椎体骨折复位效果相关因素。[结果]经过手术治疗患者伤椎前缘高度、Cobb角及椎管狭窄度均得到明显矫正(P<0.05),相关性分析显示:术后椎体前缘高度矫正度与受伤至手术时间(r=-0.194,P=0.018)、术前椎体前缘高度(r=-0.661,P=0.001)相关;术后Cobb角矫正度与受伤至手术时间(r=-0.296,P=0.001)、术前Cobb角(r=0.727,P=0.001)相关;术后椎管狭窄矫正度与受伤至手术时间(r=-0.275,P=0.001)、术前椎管狭窄程度(r=0.713,P=0.001)相关。依据受伤至手术时间长短将患者分成≤7 d组(88例)和>7 d组(60例)两组,通过手术治疗,受伤时间≤7 d组椎体前缘高度、Cobb角和椎管狭窄度矫正均优于受伤时间>7 d组(P<0.05)。[结论]对胸腰段椎体不稳定型骨折患者,应在完善相关检查的基础上尽早进行手术治疗,以期达到较好的复位效果。[Objective] To investigate the factors influencing the reduction quality of thoracolumbar fractures.[Methods] A retrospective analysis was made on 148 patients with single segment thoracolumbar fractures who underwent surgical treatment in our hospital between January 2012 and December 2015. Patients＇ data were collected and analyzed for exploring the factors related to the reduction trait of thoracolumbar fractures. [Results] The height of anterior vertebral body, Cobb angle and spinal stenosis were significantly improved after surgery（P〈0.05）. Spearman correlation analysis revealed that the postoperative correction in height of anterior vertebral body were significantly related to the interval from injury to operation（r=-0.194, P=0.018）, and the preoperative height of anterior vertebral body（r=-0.661, P= 0.001）; additionally, the postoperative correction of Cobb angle were remarkably related to the interval from injury to operation（r=-0.296, P=0.001）, and the preoperative Cobb angle（r=0.727, p=0.001）;furthermore, the postoperative correction of spinal stenosis were significantly associated with the interval from injury to operation（r=-0.275, P= 0.001）, and the preoperative spinal stenosis（r=0.713,P=0.001）. In term of the interval from injury to surgery, the patients were divided into ≤7 days group（n=88 cases） and 〉7days group（n=60 cases）. The corrections in height of anterior vertebral body, Cobb angle and spinal stenosis of the ≤7 days group were statistically better than those in the 〉7 days group（P〈0.05）. [Conclusion] For a patient with unstable thoracolumbar fractures, surgery treatment should be carried out as soon as possible after necessary inspection to achieve a good reduction outcome.

关 键 词：胸腰段椎体骨折 伤椎前缘高度 COBB角 椎管狭窄度 复位效果 

分 类 号：R687.3[医药卫生—骨科学]