经椎弓根内固定术联合椎体成形术治疗创伤性胸腰段脊柱骨折  

Transpedicular internal fixation combined with vertebroplasty in treatment of traumatic fracture of thoracic and lumbar vertebra

作　　者：李佳[1] 王磊[1] 陈华[1] LI Jia;WANG Lei;CHEN Hua(Department of Orthopedics,Qinghai Provincial People＇s Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海省人民医院骨科,青海西宁810000

出　　处：《中国临床研究》2018年第10期1383-1386,共4页Chinese Journal of Clinical Research

摘　　要：目的研究分析经椎弓根内固定术联合椎体成形术治疗创伤性胸腰段脊柱骨折的临床疗效。方法选择2015年7月至2017年8月期间收治的96例中老年创伤性胸腰段脊柱骨折患者纳入研究,据随机数字表法分为研究组和对照组各48例。对照组给予经椎弓根内固定术治疗;研究组采用经椎弓根内固定术联合椎体成形术进行治疗。观察对比两组手术指标和并发症情况,观察术前、术后1个月疼痛程度、影像学评估及机体功能障碍变化情况。结果研究组患者术中出血量及住院时间较对照组明显降低,差异有统计学意义(P均<0. 01)。术后1个月与术前比较,两组患者伤椎前缘高度所占百分比明显增大,Cobb's角角度明显减小(P均<0. 01);且研究组患者伤椎前缘高度所占百分比较对照组稍大,椎体前缘矫正丢失度略低,但组间差异无统计学意义(P均> 0. 05)。两组术前视觉模拟评分法(VAS)及Oswestry功能障碍指数(ODI)评分相比,差异无统计学意义(P均> 0. 05);术后1个月研究组VAS评分较对照组低,ODI评分较对照组高,差异有统计学意义(P均<0. 01);研究组患者术后并发症总发生率6. 25%(3/48)与对照组的8. 33%(4/48)比较差异无统计学意义(P> 0. 05)。结论经椎弓根内固定术联合椎体成形术治疗创伤性胸腰段脊柱骨折效果确切,有利于增加患者脊柱的稳定性,减轻机体损伤,预防患者术后脊柱后凸,进而减轻疼痛,改善远期预后康复质量。Objective To investigate the clinical efficacy of transpedicular internal fixation combined with vertebroplasty in the treatment of traumatic fracture of thoracic and lumbar vertebra. Methods A total of 96 patients with traumatic fracture of thoracic and lumbar vertebra who received treatment at Qinghai Provincial People＇ s Hospital from July 2015 to August 2017 were selected and divided into control group and study group randomly（48 cases each）. Control group patients received transpedicular fixation and study group patients received transpedicular internal fixation combined with vertebroplasty. The operation indexes and complication were observed in two groups. The changes of pain degree,imaging evaluation and body dysfunction were observed before and after the operation. Results The intra-operative bleeding and hospital stay in observation group were significant lower than those in control group（all P〈0.01）. One month after the operation,the Cobb＇s angle was lower and fracture vertebra height was higher in study group（all P〈0.01）. There were no significant differences at visual analogue score（VAS） and the Oswestry disability index（ODI） in two groups before the operation（all P〈0.05）. One month after the operation,the VAS was lower and ODI was higher in two groups（all P〈0.01）. Compared with control group,the VAS was lower and ODI was higher in study group after the operation（all P〈0.01）. The total complication rate in study group was not significant lower than that in control group [6. 25%（3/48） vs8. 33%（4/48）,P〈0.05]. Conclusion Transpedicular internal fixation combined with vertebroplasty is effective in the treatment of traumatic fracture of thoracic and lumbar vertebra,which could increase the stability of the spine,reduce the body injury and prevent postoperative kyphosis,in order to alleviate pain and improve the long-term prognosis and rehabilitation quality.

关 键 词：胸腰段脊柱骨折 创伤性 经椎弓根内固定术 椎体成形术 远期 预后 康复 

分 类 号：R683.2[医药卫生—骨科学]