经伤椎与跨节段椎弓根螺钉内固定治疗单节段胸腰椎骨折  

Analysis on the clinical efficacy of pedicle screw fixation via or across the injured vertebra for single-segment thoracolumbar fractures

作　　者：王东[1] 高宏斌[1] 胡祥怀[1] WANG Dong;GAO Hongbin;HU Xianghuai(Department of Orthopaedics,Affiliated Chaohu llospital of Anhui Medical Lniversity,Chaohu 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院骨科一病区,安徽巢湖238000

出　　处：《皖南医学院学报》2018年第5期446-449,共4页Journal of Wannan Medical College

摘　　要：目的:对比并研究经伤椎与跨节段椎弓根螺钉内固定治疗单节段胸腰椎骨折的临床疗效。方法:将2016年1月～2017年3月收治且符合纳入标准的30例单节段胸腰椎骨折患者随机分别经伤椎(对照组)和跨节段椎弓根螺钉内固定(实验组),记录两组患者手术时间、术中出血量、骨折愈合情况及并发症,比较术前及术后患者Cobb角、伤椎椎体前后缘高度百分比、疼痛视觉模拟评分(VAS)及功能独立性评估表评分(FIM)。结果:对照组在手术时间与术中出血上优于实验组(P<0.05)。两组患者经过手术治疗后,Cobb角及伤椎前后缘高度百分比在术前和术后3个月差异无统计学意义(P> 0.05),而在术后6个月时相比,实验组患者优于对照组(P<0.05)。两组患者VAS评分和FIM评分在手术治疗前后相比差异无统计学意义(P>0.05),但与术前相比,两组患者经复位内固定后评分均得到改善(P<0.05)。结论:经伤椎和跨节段椎弓根螺钉固定均能对单节段胸腰椎骨折形成良好的复位固定效果,跨节段椎弓根螺钉固定在缩短手术时间和减少术中出血中占有一定的优势,经伤椎椎弓根螺钉固定远期临床效果更佳,值得临床推广。Objective ：To compare the clinical outcomes of pedicle screw fixation through or across the injured vertebra in treating single-segment thoraco- lumbar fractures. Methods：Thirty eligible patients with single-segment thoracolumbar fractures were included from January 2016 to Mareh 2017, and randomly allocated to two groups by the surgical modality. The two groups were maintained concerning the operative time, intraoperative blood loss, fracture healing and postoperative complications, and compared pertinent to the changes of Cobb＇s angle, anterior and posterior height of the injured vertebrae, visu- al analogue scale （VAS） and scoring on the functional independence measure （lqM）scale before and after operation. Results：Patients in the control group had shorter operative time and lower intraoperative blood loss than those in the experimental group（P〈0.05） ,yet the two groups were insignificant in the changes of Cobb＇s angle, anterior and posterior height before operation and 3 months after operation（P〉0.05） , and the changes were more significant in the experimental group than the control group 6 months after operation （P〈0.05） .The VAS and FIM scores were not statistically dift）rent before and after oper- ation between groups （P〉0.05）, yet were improved a lot following operation in two groups （P〈0.05）.Conelusion：Pedicle screw fixation via or across the injured vertebra can lead to better restoration of the single-segment thoracolumbar fractures. Fixation across the injured vertebra can shorten the operative time and reduce intraoperative blood loss,and fixation via the injured vertebra can be better in long-term effect and worthy of wider clinical recommendation.

关 键 词：胸腰椎骨折 椎弓根螺钉 经伤椎 跨节段 

分 类 号：R687.32[医药卫生—骨科学]