经伤椎单节段固定术与跨伤椎短节段固定术治疗胸腰椎骨折的效果比较  

Comparison of the effect of single-segment fixation with trans-injured vertebrae and short-segment fixation with trans-injured vertebrae

作　　者：崔利宾[1] 袁鑫[1] 鲁世保[2] 陈学明[1] 张衍军[1] CUI Libin;YUAN Xin;LU Shibao;CHEN Xueming;ZHANG Yanjun(Department of Spine Surgery,Beijing Luhe Hospital,Capital Medical University,Beijing101149,China;Department of Orthopedics,Xuanwu Hospital,Capital Medical University,Beijing100053,China)

机构地区：[1]首都医科大学附属北京潞河医院脊柱外科,北京101149 [2]首都医科大学宣武医院骨科,北京100053

出　　处：《中国医药导报》2020年第21期92-95,99,共5页China Medical Herald

基　　金：首都卫生发展科研基金项目(首发2014-2-2032)。

摘　　要：目的比较经伤椎单节段固定术与跨伤椎短节段固定术在胸腰段骨折治疗中的效果。方法选取2017年4月—2019年3月首都医科大学附属北京潞河医院手术治疗的60例连续的具备经伤椎单节段固定条件的胸腰段骨折患者为研究对象,按照随机数字表法将其分为试验组与对照组,每组30例。试验组接受经伤椎单节段固定术,对照组接受跨伤椎短节段固定术,分别于术后3 d开始进行至少12个月的随访,随访指标包括患者疼痛视觉模拟(VAS)评分、Oswestry评分、伤椎椎体压缩率、矢状面Cobb角,比较两种手术的临床疗效和矫正度保持方面。结果随访结束后试验组有28例,对照组有25例。末次随访时,试验组和对照组椎体压缩率、矢状面Cobb角与术前比较明显降低(P<0.05),且试验组明显低于对照组(P<0.05)。试验组和对照组术前、末次随访时的VAS评分及Oswestry功能障碍指数(ODI)评分比较,差异无统计学意义(P>0.05)。与术前比较,两组末次随访VAS评分及ODI评分均降低(P<0.05),两组间比较差异无统计学意义(P>0.05)。试验组手术时间明显短于对照组(P<0.05),两组术中出血量和平均住院日比较,差异无统计学意义(P>0.05)。两组均未出现伤口感染,迟发神经功能损害等严重并发症。试验组无螺钉及钛棒弯曲断裂,有2例出现螺钉松动。对照组有1例出现螺钉断裂,3例出现螺钉松动。结论经伤椎单节段固定术及跨伤椎短节段固定术在治疗AO分型A1型及A3.1型胸腰段骨折时均可使椎体高度和矢状面Cobb角得到满意恢复。经伤椎单节段固定术在治疗AO分型A1型及A3.1型胸腰段骨折时在术后畸形矫正、保持及手术时间方面优于跨伤椎短节段固定术。Objective To compare the effect of monosegmental transvertebral fixation and short segment fixation for thoracolumbar fracture.Methods From April 2017 to April 2019,60 consecutive patients with thoracolumbar fracture treated by operation in Beijing Luhe Hospital,Capital Medical University were selected as the research objects,and they were divided into experimental group and control group according to the random number table method,with 30 patients in each group.Experimental group accepted the injured vertebral single segmental fixation,the control group accepted across vertebral short segmental fixation,respectively in postoperative three days to begin for at least 12 months of follow-up,patients with follow-up indicators including visual analogue scale(VAS)score,Oswestry disability index scores(ODI),injury spinal vertebral compression rate,sagittal Cobb Angle,the surgery postoperative clinical curative effect and correct degree of the two operations were compared.Results At the end of follow-up,there were 28 cases in the experimental group and 25 cases in the control group.At the last follow-up,the vertebral compression rate and the sagittal Cobb angle of the two groups were significantly lower than those before operation(P<0.05),and the experimental group was significantly lower than the control group(P<0.05).Compared with before operation,the VAS scores and ODI scores in the last follow-up of both groups were reduced(P<0.05),and there was no statistically significant difference between the two groups(P>0.05).The operation time of the experimental group was significantly shorter than that of the control group(P<0.05), and there was no statistically significant difference between the two groups in terms of intraoperative blood loss and average length of stay (P > 0.05). There were no serious complications such as wound infection, delayed nerve function damage in both groups. In the experimental group, there was no screw or titanium rod bending fracture, and screw loosening occurred in two cases. In the control

关 键 词：胸腰椎骨折 伤椎 单节段固定 短节段固定 

分 类 号：R683.2[医药卫生—骨科学]