中青年胸腰椎爆裂骨折经后入路钉棒系统内固定联合椎体后凸成形术的短期疗效分析  

Short-term curative effect analysis of thoracolumbar burst fractures in young and middle-aged patients with posterior screw and rod system internal fixation combined with kyphoplasty

作　　者：刘正伟 董乐乐[2] 于泽[1] 王丰[1] 冯子田 LIU Zhengwei;DONG Lele;YU Ze;WANG Feng;FENG Zitian(Baotou Medical College,Baotou 014060,China;The First Affiliated Hospital of Baotou Medical College)

机构地区：[1]内蒙古科技大学包头医学院,内蒙古包头014060 [2]内蒙古科技大学包头医学院第一附属医院

出　　处：《包头医学院学报》2021年第5期62-66,共5页Journal of Baotou Medical College

摘　　要：目的:探究经后入路钉棒系统内固定联合椎体后凸成形术治疗中青年胸腰椎爆裂骨折的短期疗效。方法:选取2015年1月至2020年12月收治的75例胸腰椎单椎体爆裂性骨折病例,按照手术方式的不同分为两组,A组35例患者行单纯后入路钉棒系统内固定治疗,B组35例患者行后入路钉棒系统内固定联合椎体后凸成形术治疗,比较两组患者在手术前后ASIA(美国脊髓损伤协会)评分、VAS评分、椎体高度恢复率、后凸矫正率等指标变化。结果:1例患者术后脑脊液漏,1例患者术后切口愈合不良,经对症治疗均顺利愈合,其余患者均顺利康复;A组手术时间、术中失血量均少于B组(P<0.05);两组术后24 h引流量差异无统计学意义(P>0.05);A组术后下地时间及术后住院时间均长于B组(P<0.05);两组VAS评分均较术前改善(P<0.05),术后14 d及术后3个月,A组VAS评分低于B组(P<0.05);与术前相比,术后两组患者椎体高度压缩率、椎体后凸角等影像学指标改善(P<0.05),两组患者在椎体高度恢复率、后凸矫正率差异无统计学意义(P>0.05)。结论:后路短节段钉棒系统内固定联合椎体后凸成形术治疗中青年胸腰椎爆裂骨折时,手术时间延长、术中出血量增加,但能快速减轻患者疼痛,维持伤椎稳定性。Objective:To explore the short-term effect of posterior nail-bar system internal fixation combined with kyphoplasty in the treatment of thoracolumbar burst fractures in young and middle-aged adults.Methods:75 cases of thoracolumbar single vertebral burst fractures admitted from January 2015 to December 2020 were selected and divided into two groups according to different surgical methods.In group A,35 patients underwent a simple posterior approach in the nail-and-rod system fixation treatment,and 35 patients in group B were treated with posterior screw rod system internal fixation combined with kyphoplasty.The ASIA(American Spinal Injury Association)score,VAS score,vertebral height recovery rate and kyphosis correction rate were compared between the two groups before and after surgery.Results:1 patient had postoperative cerebrospinal fluid leakage,and 1 patient had poor postoperative incision healing,but both of them were healed smoothly after symptomatic treatment.The rest of the patients recovered smoothly.The operation time and intraoperative blood loss of group A were less than those of group B(P<0.05))and there was no statistically significant difference in drainage volume between the two groups at 24 h after surgery(P>0.05);the postoperative time to ground and postoperative hospital stay in group A were longer than those in group B(P<0.05);VAS score of group A was lower than that of group B at 14 d and 3 months after surgery(P<0.05).Compared with preoperation,postoperative imaging indicators such as vertebral height compression rate and kyphosis Angle of the two groups were improved(P<0.05),and there was no statistical significance in vertebral height recovery rate and kyphosis correction rate between the two groups(P>0.05).Conclusion:In the treatment of thoracolumbar burst fractures of young and middle-aged and young adults with posterior short-segment nail-rod system internal fixation and kyphoplasty,the operation time is prolonged and the intraoperative blood loss increases,but it can quickly reduce the

关 键 词：中青年 胸腰椎爆裂骨折 椎弓根钉内固定术 椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]