可调式三维牵引系统在无神经损伤胸腰椎骨折非手术治疗中应用的效果观察  

Effect of adjustable three-dimensional traction system on neurologically intact thoracolumbar fractures

作　　者：林志宏 张文彬 吕良友 许巩固 LIN Zhihong;ZHANG Wenbin;LV Liangyou;XU Gonggu(Department of Orthopedics,Tong'an District Hospital of Traditional Chinese Medicine,Xiamen,Fujian 361100,China)

机构地区：[1]厦门市同安区中医医院骨科,福建361100

出　　处：《中国骨与关节损伤杂志》2023年第3期225-229,共5页Chinese Journal of Bone and Joint Injury

基　　金：福建省中医药科研课题研究项目(wst201203)。

摘　　要：目的 观察可调式三维牵引系统在无神经损伤胸腰椎骨折非手术治疗中应用的效果。方法 回顾性分析自2016-07—2019-05采用非手术治疗的186例无神经损伤胸腰椎爆裂骨折,所有患者在治疗过程中采用可调式三维牵引系统辅助牵引复位治疗。比较治疗前、治疗后1个月、治疗后6个月、治疗后12个月伤椎椎体压缩率、伤椎椎体前缘高度百分比、伤椎Cobb角、疼痛VAS评分。结果 186例均获得随访,随访时间为13~36个月,平均22.5个月。治疗过程中所有患者均未出现脊髓神经损伤症状,末次随访时均未出现创伤性后凸畸形、顽固性腰背部疼痛。治疗前后伤椎椎体压缩率、伤椎椎体前缘高度百分比、伤椎Cobb角差异有统计学意义(P<0.05),治疗后1个月影像学参数较治疗前明显改善,治疗后6个月影像学参数治疗后1个月明显改善;治疗后12个月影像学参数较治疗后6个月有所丢失,但是差异无统计学意义(P>0.05)。治疗前后疼痛VAS评分比较差异有统计学意义(P<0.05),治疗后1、6、12个月疼痛VAS评分持续降低。结论 采用非手术治疗单纯胸腰椎骨折时,可调式三维牵引系统可作为一种有效的辅助治疗方法,可复位骨折椎体、改善脊柱后凸畸形、减轻患者胸腰背部疼痛。Objective To observe the effect of adjustable three-dimensional traction system in conservative treatment of neurologically intact thoracolumbar fractures.Methods A total of 186 patients diagnosed as neurologically intact thoracolumbar fractures from July 2016 to May 2019 were retrospectively analyzed.They were all treated with adjustable three-dimensional traction system assisted traction reduction during the conservative treatment.The vertebral compression rate(VBCR),anterior vertebral height percentage(PAHC),Cobb angle and visual analogue scale scores were recorded before treatment,at the first,the 6th and the 12th month after treatment.Results All patients were followed up for 13-36 months,with an average of 22.5 months.During our treatment,the secondary spinal cord or nerve injury occurred in no patients.All patients recovered from the trauma without complications,such as traumatic kyphosis and intractable back pain,occurring at the last follow-up.The VBCR,PAHC and Cobb angle were significantly improved after treatment compared with those before treatment,and the differences were statistically significant(P<0.05).The VBCR,PAHC and Cobb angle were significantly improved at the first month compared with those before treatment.At the 6th month,all imaging parameters improved significantly compared with those at the first month.However,these coefficients at the 12th month after treatment were lost to some extent compared with those at the 6th month after treatment,but the differences had no statistical significance(P>0.05).There was a statistically significant difference in VAS score before and after treatment(P<0.05).The VAS score continued to decrease from the first month to the 12th month after treatment.Conclusion Adjustable three-dimensional traction system can reduce vertebral fractures,improve the kyphosis deformity and relieve low back pain.Thus,it can be used as an effective auxiliary therapy in conservative treatment of neurologically intact thoracolumbar fractures.

关 键 词：无神经损伤胸腰椎骨折 非手术治疗 可调式三维牵引系统 椎体压缩率 伤椎Cobb角 

分 类 号：R683.2[医药卫生—骨科学]