短节段钉棒固定联合伤椎置钉治疗胸腰椎骨折的疗效分析  

Analysis of the curative effect of short-segment nail rod fixation combined with traumatic vertebral nail placement in the treatment of thoracolumbar fractures

作　　者：谭章勇 汪建良[1] 许科峰 黄智慧[1] 姚建 Tan Zhangyong;Wang Jianliang;Xu Kefeng;Huang Zhihui;Yao Jian(Department of Orthopedics,the 904 Hospital of Joint Service Support Force of the Chinese PLA,Jiangsu Wuxi 214044,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院骨科,江苏无锡214044

出　　处：《中国医刊》2021年第8期881-884,共4页Chinese Journal of Medicine

基　　金：无锡市“双百”中国青年医疗卫生拔尖人才培养计划项目(NZ2019030)。

摘　　要：目的探讨在胸腰椎骨折患者中应用后路短节段固定(short-segment posterior instrumentation,SSPI)联合伤椎置钉的疗效及预防术后椎体“空壳”的效果。方法选取2015年1月至2020年6月解放军联勤保障部队第904医院收治的胸腰椎骨折患者84例,根据治疗方法的不同分为传统组(44例)和联合组(40例)。传统组患者接受单纯SSPI治疗,联合组患者接受SSPI联合伤椎置钉治疗。比较两组患者的手术时间、术中出血量、引流管拔除时间、住院时间及并发症发生情况,术后椎体“空壳”发生及愈合状况,术前及末次随访时的伤椎前缘压缩程度及疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)。结果两组患者手术时间、术中出血量、引流管拔除时间及住院时间比较差异无显著性(P>0.05)。联合组术后并发症发生率(5.00%)明显低于传统组(22.72%),术后椎体“空壳”发生率(20.0%)明显低于传统组(88.6%),差异均有显著性(P<0.05),而两组“空壳”愈合情况差异无显著性(P>0.05)。术前两组伤椎前缘压缩程度比较差异无显著性(P>0.05),末次随访时两组伤椎前缘压缩程度均明显低于术前,且联合组明显低于传统组,差异有显著性(P<0.05)。术前两组VAS评分及ODI比较差异无显著性(P>0.05),末次随访时两组VAS评分及ODI均明显低于术前,且联合组明显低于传统组,差异有显著性(P<0.05)。结论SSPI联合伤椎置钉治疗胸腰椎骨折具有安全、高效、稳定的优势,可有效维持伤椎高度,预防椎体“空壳”形成,从而获得满意的疗效。Objective To investigate the effect of posterior short-segment posterior instrumentation(SSPI)combined with screw placement in the thoracolumbar vertebral fractures and the prevention of postoperative vertebral“hollow shells”.Method A total of 84 patients with thoracolumbar fractures admitted to the 904th Hospital of the Joint Service Support Force of the People’s Liberation Army from January 2015 to June 2020 were selected and divided into traditional group(44 cases)and combined group(40 cases)according to different treatment methods.Patients in the traditional group received SSPI therapy alone,and patients in the combination group received SSPI combined with screw placement in the injured vertebrae.The operation time,intraoperative blood loss,drainage tube removal time,hospitalization time and complications of the two groups were compared,the occurrence and healing of the postoperative vertebral body“empty shell”,and the anterior edge of the injured vertebra before operation and the last follow-up Compression degree and pain visual analogue scale(VAS)score,Oswestry disability index(Oswestry disability index,ODI).Result There was no significant difference in the operation time,intraoperative blood loss,drainage tube removal time and hospital stay between the two groups(P>0.05).The postoperative complication rate(5.00%)of the combined group was significantly lower than that of the traditional group(18.18%),the difference is significant(P<0.05).The incidence of“empty shells”in the combined group(20.0%)was significantly lower than that of the traditional group(88.6%),and the difference was significant(P<0.05),while there was no significant difference in the healing of“empty shells”between the two groups(P>0.05).There was no significant difference in the compression degree of the front edge of the injured vertebrae between the two groups before operation(P>0.05).At the last follow-up,the compression degree of the front edge of the injured vertebrae in the two groups was significantly lower than tha

关 键 词：胸腰椎骨折 后路短节段固定 伤椎置钉 

分 类 号：R683.2[医药卫生—骨科学]