经伤椎单节段固定与跨伤椎短节段固定治疗胸腰椎骨折的临床疗效对比研究  

Comparison of clinical efficacy between injured vertebra mono-segmental fixation and across injured verte-bra short segmental fixation in the treatment of thoracolumbar fracture

作　　者：何平 罗剑[1] 王琨 尹国栋[3] HE Ping;LUO Jian;WANG Kun;YIN Guodong(Department of Spine and Joint Surgery,the First Naval Hospital of Southern Theater Command,Zhanjiang 524000,China;Department of Spine Surgery Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China;不详)

机构地区：[1]南部战区海军第一医院脊柱关节科,广东湛江524000 [2]上海交通大学医学院附属仁济医院脊柱外科,上海200127 [3]解放军第923医院脊柱外科,南宁530021

出　　处：《实用医学杂志》2021年第5期606-610,共5页The Journal of Practical Medicine

基　　金：国家自然科学基金青年项目(编号:81802139);上海交通大学“医工交叉研究基金”青年项目(编号:YG2017QN51);上海交通大学医学院附属仁济医院临床科研创新培育基金计划(编号:PYII-17-011);广西自然科学基金项目(编号:2017GXNSFAA198364)。

摘　　要：目的对比经伤椎单节段固定和跨伤椎短节段固定对于胸腰椎骨折治疗的临床疗效。方法从2015年3月至2018年3月,选择我院90例胸腰椎骨折患者作为研究对象。以数字法随机分为观察组45例以及对照组45例。观察组患者行经伤椎单节段固定,对照组患者行跨伤椎短节段固定。随访时间为24个月。测量伤椎及其上下相邻正常椎体的前缘高度、伤椎后凸Cobb角。比较两组患者伤椎椎体前缘高度比、矢状面Cobb角、矫正度丢失及手术时间、出血量、切口长度、生存质量、术后并发症。结果两组患者手术时间、术后生存质量等比较差异均无统计学意义(P>0.05),两组患者的术后并发症、出血量、切口长度,末次随访的生存质量差异有统计学意义(P<0.05),两组患者生存质量、椎体前缘高度及Cobb角均获得显著恢复,但末次随访时经伤椎单节段固定组骨折椎体前缘高度和矢状面Cobb角的保持优于跨伤椎短节段固定组,差异有统计学意义(P<0.05)。结论经伤椎单节段固定治疗胸腰椎骨折的中短期临床效果优于跨伤椎短节段固定,手术对患者造成的创伤更小、并发症更少。Objective To compare the clinical effect of injured vertebra mono-segmental fixation and across injured vertebra shortsegmental fixation in the treatment of thoracolumbar fractures.Methods From March 2015 to March 2018,90 patients with thoracolumbar fractures in our hospital were selected and randomly divided into observation group(n=45)and control group(n=45).Patients in the observation group were treated with injured vertebra mono-segmental fixation,while patients in the control group were treated with across injured vertebra short segmental fixation.All of patients were followed up for 24 months.The anterior height ratio of injured vertebral body,sagittal Cobb angle,loss of correction,operation time,blood loss,incision length,quality of life and postoperative complications were compared between the two groups.Results There were no significant differences in operation time and quality of life between two groups(P>0.05).There were significant differences in postoperative complications,blood loss,incision length and quality of life at the last follow-up between the two groups(P<0.05).The quality of life,anterior vertebral height and Cobb angles were significantly restored in both of two groups,but the last follow-up,the anterior height and sagittal Cobb angle of the fractured vertebra body in the mono-segment fixation group were better than those in the across injured vertebra short segment fixation group,and the difference was statistically significant(P<0.05).Conclusions The short-term and medium-term clinical effect of injured vertebra mono-segment fixation in the treatment of thoracolumbar fractures is better than that ofacross injured vertebra short segmental fixation,and the operation of mono-segment fixation causes less trauma and complications.

关 键 词：胸腰椎骨折 经伤椎单节段固定 跨伤椎短节段固定 

分 类 号：R683.2[医药卫生—骨科学]