下腰椎骨折术前胸腰椎损伤分类及严重程度评分对术后近期疗效的影响  

Effect of preoperative thoracolumbar injury classification and severity score on postoperative short-term outcome of lower lumbar fracture

作　　者：万峻莱 赵广[1] 张治宇[1] WAN Jun-lai;ZHAO Guang;ZHANG Zhi-yu(Department of Orthopaedics,Fourth Affiliated Hospital of China Medical University,Shenyang 110001,Liaoning,China)

机构地区：[1]中国医科大学附属第四医院骨科,沈阳110001

出　　处：《脊柱外科杂志》2020年第3期176-179,共4页Journal of Spinal Surgery

摘　　要：目的探讨下腰椎骨折术前胸腰椎损伤分类及严重程度(TLICS)评分对术后近期疗效的影响。方法回顾性分析2009年2月-2018年9月收治的37例下腰椎骨折患者资料。根据患者术前TLICS评分分组:A组TLICS评分>4分(22例),B组TLICS评分≤4分(15例)。记录2组患者术前、术后3个月的伤椎椎体前缘高度比、矢状位Cobb角、疼痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数(ODI),并计算改善率。结果2组患者术后3个月伤椎椎体前缘高度比、矢状位Cobb角、VAS评分和ODI均较术前显著改善,差异有统计学意义(P<0.05)。B组术前伤椎椎体前缘高度比、术前和术后VAS评分及术后ODI均优于A组,差异有统计学意义(P<0.05)。A组伤椎前缘高度比和VAS评分改善率均优于B组,差异有统计学意义(P<0.05)。结论下腰椎骨折患者术后近期伤椎椎体前缘高度比、矢状位Cobb角、VAS评分及ODI均有良好恢复,且手术对术前TLICS评分>4分的患者在伤椎椎体前缘高度恢复和疼痛减轻程度上的效果更加显著。Objective To investigate the effect of preoperative thoracolumbar injury classification and severity(TLICS)score on the short-term postoperative outcome of lower lumbar fracture.Methods From February 2009 to September 2018,the data of 37 patients with lower lumbar fracture were analyzed retrospectively.According to the preoperative TLICS score,the patients were divided into 2 groups:group A with TLICS score>4(22 cases),group B with TLICS score≤4(15 cases).The ratio of injured vertebra anterior edge height,sagittal Cobb’s angle,visual analogue scale(VAS)score and Oswestry disability index(ODI)were recorded before and 3 months after operation,and the improvement rate was calculated.ResultsThe ratio of injured vertebra anterior edge height,sagittal Cobb’s angle,VAS score and ODI at postoperative 3 months in the 2 groups were significantly improved compared with those at pre-operation,all with a statistical significance(P<0.05).The preoperative ratio of injured vertebra anterior edge height,pre-and post-operative VAS score and postoperative ODI in group B were better than those in group A,all with a statistical significance(P<0.05).The improvement rate of ratio of injured vertebra anterior edge height and VAS score in group A were better than those in group B,all with a statistical significance(P<0.05).Conclusion Patients with lower lumbar fracture have a good recovery of the ratio of injured vertebra anterior edge height,sagittal Cobb’s angle,VAS score and ODI at the short-term post-operation.Patients with preoperative TLICS score>4 have a more significant effect on the recover of injured vertebra anterior edge height and pain relief.

关 键 词：腰椎 脊柱骨折 预后 

分 类 号：R683.2[医药卫生—骨科学]