单纯短节段椎弓根钉固定与经伤椎固定在A型胸腰椎骨折中的临床对比  

Clinical comparison of simple short segment pedicle screw fixation and vertebral fixation in thoracolumbar fracture of type A

作　　者：南运东[1] NAN Yun-dong(the Second Department of Orthopaedics,the First People＇s Hospital of Shangqiu,Shangqiu,Henan,476000,China)

机构地区：[1]商丘市第一人民医院骨二科,河南商丘476000

出　　处：《颈腰痛杂志》2018年第5期561-564,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨短节段内固定治疗AO分型为A型的胸腰椎骨折中,经伤椎置钉与否对疗效的影响。方法自2011-06-2015-01收治70例A型胸腰椎骨折患者,均采用短节段椎弓根钉内固定手术治疗,其中32例予以伤椎置钉,另38例单纯行跨伤椎固定。对两组患者的临床疗效进行对比分析。结果 70例患者术后,其伤椎前缘高度压缩率、后凸角均获得良好的矫正效果,且疼痛VAS评分亦有明显改善;组间对比中,虽然A组在术后即刻的伤椎矫正值低于B组、取出内固定后的矫正丢失值高于B组,但均无统计学差异(P>0.05);且两组在疼痛VAS评分改善效果也较为相近(P>0.05)。另外,两组术后均出现数例内固定松动、断裂现象,其中A组13.2%,高于B组的9.4%,但无统计学差异(P>0.05)。结论在单纯的AO-A型胸腰椎骨折行短节段后路椎弓根钉内固定治疗中,伤椎置钉虽然有助于降低内固定失败率和减少伤椎术后的矫正度丢失,但其效果并不明显。Objective To investigate the effect of short segment internal fixation on the treatmentof thoracolumbar fractures with AO type A. Methods From June 2011 to January 2015, 70 cases oftype A thoracolumbar fractures were treated with short segment pedicle screw fixation, of which, a totalof 32 cases were treated with pedicle screw fixation, and the other 38 cases were treated with a singlelateral pedicle screw fixation. The clinical efficacy of the two groups was compared. Results Aftersurgery, the anterior vertebral height, kyphosis compression rate had good correction effect, and thepain VAS score also improved significantly; but the comparison between the two groups, the immediatepostoperative vertebral correction value in A group was lower than B group, remove the correction offixed value loss in A group was higher than B group, but there was no significant difference （P〉0.05）.And the pain VAS score improvement effect in the two groups was similar （P〉0.05）. In addition, therewere several cases of internal fixation loosening and fracture in the two groups, the A group was13.2%, which was higher than B group, but there was no statistically siginficant difference （P〉0.05）.Conclusion In type AO-A thoracolumbar spine fracture treatment for short segment pedicle screwinternal fixation, vertebral pedicle screw although helps to reduce the failure rate of internal fixationand reduce postoperative vertebral correction loss, but the effect is not obvious.

关 键 词：A型胸腰椎骨折 后路短节段内固定 椎弓根钉 伤椎置钉 

分 类 号：R683.2[医药卫生—骨科学]