短节段固定联合骨折椎体置钉治疗胸腰椎爆裂性骨折的效果分析  

Therapeutic effects of short segment fixation combined with fracture vertebra screw setting technique on thoracolumbar burst fracture

作　　者：吴显培 李森 唐建东 柯宝毅 秦壁松 WU Xianpei;LI Sen;TANG Jiandong(Guilin Municipal People’s Hospital,Guangxi,Guilin 541002,China)

机构地区：[1]广西壮族自治区桂林市人民医院

出　　处：《河北医药》2019年第13期2036-2039,共4页Hebei Medical Journal

摘　　要：目的比较后路短节段椎弓根钉棒固定中应用骨折椎体置钉(伤椎置钉)治疗胸腰椎爆裂性骨折的临床疗效。方法2014年6月至2017年6月收治的胸腰椎爆裂性骨折患者60例,按照随机数字表法分为对照组和试验组,每组30例。2组均采用椎弓根钉棒固定后路跨骨折椎的短节段,对照组骨折椎体不置钉,试验组加骨折椎体置钉。比较2组手术耗时、出血量、住院时间及并发症发生情况。记录术前、术中X线片,术后6个月时的X线片及三维CT片。测量术前、术中及术后6个月骨折椎体高度、Cobb角等;计算出骨折椎体的高度矫正率;记录患者的Oswestry功能障碍指数。对比2组参数的差异。结果2组平均手术时间、总出血量、住院时间、术后6个月时Oswestry功能障碍指数及并发症发生率比较,差异均无统计学意义(P>0.05);2组术中骨折椎体高度矫正率、Cobb角矫正率比较,差异无统计学意义(P>0.05);试验组患者术后6个月时骨折椎体高度丢失率及Cobb角丢失率少于对照组,差异有统计学意义(P<0.01)。结论后路短节段椎弓螺钉固定联合骨折椎体置钉治疗胸腰椎爆裂性骨折的长期疗效较好,可有效保持患者椎体高度,减少矫正度丢失,促进患者术后恢复,推荐临床应用。Objective To investigate the therapeutic effects of short segment fixation combined with fracture vertebra screw setting technique on thoracolumbar burst fracture. Methods A total of 60 patients with thoracolumbar burst fractures who were admitted and treated in our hospital from June 2014 to June 2017 were divided into control group(n = 30) and experimental group(n = 30). The patients in both groups were treated by trans-fracture vertebra pedicle screw fixation of posterior short segment,and the patients in control group were not set screw fixation in the fracture vertebra,however,the patients in experimental group were set screw fixation in the fracture vertebra. The average operation time,the average bleeding volume,the hospital stay after operation and the complications were observed and compared between the two groups.The preoperative and intraoperative X-ray film,the X-ray film and three-dimensional CT film at 6 months postoperation were recorded. Moreover the height and the Cobb angle of the fracture vertebra,before operation,during operation and at 6 months after operation were measured. The correction rate of the fracture vertebra height was calculated. The Oswestry dysfunction indexes of patients were recorded. The differences of the above indexes were observed and compared between the two groups.Results There were no significant differences in the average operation time,total bleeding volume,the hospital stay afer operation,the Oswestry dysfunction indexes at 6 months after operation,and the incidence rates of complications between the two groups(P > 0. 05). There were no significant differences in the intraoperative fracture vertebral height correction rate and the Cobb angle correction rate between the two groups(P > 0. 05). However the loss rate of the fracture vertebral height and the Cobb angle in the experimental group were significantly less than those in control group(P < 0. 01). Conclusion The short segment fixation combined with fracture vertebra screw setting technique in treatment of thorac

关 键 词：胸腰椎爆裂性骨折 后路短节段椎弓螺钉固定 骨折椎体置钉 椎体高度 

分 类 号：R683[医药卫生—骨科学]