胸腰椎骨折患者双侧伤椎经后路内固定联合椎弓根植骨的疗效及预后  

Effect and prognosis of bilateral vertebral internal fixation via posterior approach combined with pedicle bone graft in patients with thoracolumbar fractures

作　　者：孟祥启[1] 苏腾[1] 李萍[1] 孙成瞰 MENG Xiang-qi;SU Teng;LI Ping;SUN Cheng-kan(The People’s Hospital of Ganyu District,Lianyungang,Jiangsu 222100,China)

机构地区：[1]连云港市赣榆区人民医院外一科,江苏222100

出　　处：《创伤外科杂志》2017年第11期846-849,共4页Journal of Traumatic Surgery

摘　　要：目的探讨胸腰椎骨折患者双侧伤椎经后路内固定联合椎弓根植骨的疗效及预后。方法回顾性分析2010年1月—2015年5月接诊的80例胸腰椎骨折患者,根据手术方法不同分为观察组和对照组,各40例。观察组男性22例,女性18例;年龄24~55岁,平均38.45岁。对照组男性23例,女性17例;年龄26~53岁,平均38.51岁。观察组行后路经伤椎固定联合伤椎植骨并行后外侧植骨,对照组后路经伤椎固定术与观察组相同,常规外侧植骨。比较两组患者手术时间、术中出血量、Cobb角、伤椎前缘高度、视觉模拟评分(VAS评分)及下腰痛功能障碍指数(ODI指数)。结果两组患者手术时间、术中出血量差异无统计学意义[(76.84±13.12)min vs.(78.31±14.94)min,(218.12±34.30)m L vs.(221.92±35.69)m L,P>0.05];随访结果显示,两组患者手术后Cobb角、伤椎前缘高度均得到改善,但观察组在术后1周、3个月时Cobb角均比对照组低[(10.23±1.55)°vs.(14.38±2.17)°,(4.12±0.52)°vs.(7.43±1.30)°],伤椎前缘高度均高于对照组[(78.23±12.35)%vs.(64.84±10.54)%,(84.98±15.42)%vs.(72.42±13.09)%,P<0.05];观察组术后1周、3个月时VAS评分均低于对照组(P<0.05);观察组ODI指数在术后1周、3个月时均比对照组低(P<0.05)。结论在腰胸椎骨折患者中实施双侧伤椎经后路内固定联合椎弓根植骨治疗效果显著,值得应用推广。ObjectiveTo study effect and prognosis of bilateral vertebral internal fixation via posterior approach combined with pedicle bone graft in patients with thoracolumbar fractures.MethodsEighty patients with thoracolumbar fractures from Jan.2010to May2015in our hospital were retrospectively analyzed.They were divided randomly into observation and control groups,with40cases in each group.In the observation group,there were22males and18females,with an average age of3845years(range,24to55years);in the control group,there were23males and17females,with an average age of3851years(range,26to53years).Patients in the observation group were treated by bilateral vertebral internal fixation via posterior approach combined with pedicle bone graft,and patients in the control group were treated by the posterior vertebral fracture fixation and conventional lateral bone graft.The operative time,intraoperative blood loss,Cobb angle,anterior vertebral height,visual analogue scale(VAS)and Oswsetry Disability Index(ODI)were compared between the two groups.ResultsThere was no significant difference in operation time and intraoperative blood loss between the two groups[(7684±1312)min vs.(7831±1494)min,(21812±3430)mL vs.(22192±3569)mL,P>005];the follow up results showed that the Cobb angle and anterior vertebral height were improved in the two groups.However,at1week and three months after surgery,the Cobb angle in the observation group was lower than that of the control group[(1023±155)°vs.(1438±217)°,(412±052)°vs.(743±130)°],while the anterior vertebral height was higher than that of control group[(7823±1235)%vs.(6484±1054)%,(8498±1542)%vs.(7242±1309)%,P<005].VAS in the observation group was lower than that of the control group(P<005),and ODI in the observation group was lower than that of the control group(P<005).ConclusionBilateral vertebral internal fixation via posterior approach combined with pedicle bone graft is effective for thoracolumbar fractures,which is worthy of application and promotion.

关 键 词：腰胸椎骨折 椎弓根植骨 内固定 

分 类 号：R687.3[医药卫生—骨科学]