后路短节段内固定治疗创伤性A型胸腰椎骨折中附加伤椎强化和附加伤椎置钉的疗效比较  

Comparison of posterior short-segment internal fixation for traumatic type A thoracolumbar fracture with additional injured vertebral augmentation versus additional injured vertebral nail placement

作　　者：刘颖 曹爽 李业奎 周业金 LIU Ying;CAO Shuang;LI Yekui;ZHOU Yejin(Department of Orthopedics,the Third Affiliated Hospital of Anhui Medi-cal University,Hefei 230001,China)

机构地区：[1]安徽医科大学第三附属医院骨科,合肥230001

出　　处：《实用医学杂志》2022年第23期2980-2985,共6页The Journal of Practical Medicine

摘　　要：目的分析后路短节段内固定治疗创伤性A型胸腰椎骨折中附加伤椎强化和附加伤椎置钉的疗效,从而为临床选择提供参考。方法选取2019年1月至2021年6月入住于安徽医科大学第三附属医院骨科的创伤性A型胸腰椎骨折患者74例,33例行后路短节段内固定附加伤椎强化(伤椎强化组),41例行后路短节段内固定附加伤椎置钉(伤椎置钉组)。评价指标为手术时间、术中出血量、负重时间、视觉模拟评分(VAS)、汉化Oswestry功能障碍指数问卷表(ODI)、椎体压缩率、伤椎Cobb角以及术后1年伤椎Cobb角增大角度。结果术后随访13~24个月。两组患者在负重时间上,差异有统计学意义(P<0.05),伤椎置钉组负重时间要早于伤椎强化组。两组患者术后腰痛(VAS评分)、功能表现(ODI评分)、Cobb角和椎体压缩率比较术前均得到显著改善(P<0.05),但组间差异无统计学意义(P>0.05)。此外,尽管骨折椎体的Cobb角和椎体压缩率在术后1年得到了显著校正,但与术后1周时相比均有不同程度丢失,而组间差异无统计学意义(P>0.05)。两组在手术时间、术中出血量的比较差异无统计学意义(P>0.05)。结论在治疗创伤性A型胸腰椎骨折中,两者临床疗效相当;但附加伤椎置钉在负重时间上优于附加伤椎强化,且因前者操作简便、成熟,更适用于临床推广。Objective To analyze the curative efficacy of additional injured vertebral augmentation versus that of additional injured vertebral nail in posterior short segment internal fixation fortraumatic type A thoracolumbar fracture,so as to provide reference for clinical selection.Methods A total of 74 patients with traumatic type A thoracolumbar fracture whohad been admitted to the Department of Orthopedics,the Third Affiliated Hospital of Anhui Medical University from January 2019 to June 2021 were selected.33 of who munder went posterior short segmental internal fixation plus injured vertebra augmentation(injured vertebra augmentation group)and 41 underwent posterior short segmental internal fixation plus injured vertebra fixation(injured vertebra nail group).The surgical duration,intraoperative blood loss,weight-bearing time,visual analogue scale(VAS)score,Chinese Oswestry Disability Index(ODI),vertebral compression rate,Cobb Angle of injured vertebrae,and the increased angle in Cobb Angle of injured vertebrae one year after the procedures were assessed.Results The average follow-up was 17.7months.There was a significant difference in weight-bearing time between the two groups(P<0.05).The weightbearing time in the injured vertebra nail group was earlier than that in the injured vertebra augmentation group.The postoperative low back pain(VAS score),functional performance(ODI score),Cobb angle and vertebral compression ratio were significantly improved inboth groups,but there was no significant difference between the two groups(P>0.05).In addition,although the Cobb angle and vertebral compression ratio of the fractured vertebrae were significantly corrected one year after the procedures,they were lost at varying degrees ascompared with one week after the procedures,there were no significant differences between the two groups(P>0.05).The surgical duration and intraoperative blood loss did not differ significantly between the two groups(P>0.05).Conclusions In the treatment of traumatic type A thoracolumbar fractures,the

关 键 词：胸腰椎骨折 后路短节段内固定 经伤椎置钉 伤椎强化 自固化磷酸钙人工骨 

分 类 号：R826.64[医药卫生—临床医学]