后路切开骨折复位钉棒内固定术在脊柱胸腰段椎体骨折治疗中的临床应用价值研究  

Clinical Research of Open Reduction and Screw-rod System Fixation via Posterior Approachin Treating the Spinal and Thoracolumbar Vertebral Fracture

作　　者：黄忠福 HUANG Zhong-fu(Department of orthopedics,Shicheng county People's hospital,Ganzhou city,Jiangxi province 342700)

机构地区：[1]江西省石城县人民医院骨二科,江西石城342700

出　　处：《中国伤残医学》2023年第8期1-5,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨脊柱胸腰段椎体骨折患者采用后路切开骨折复位钉棒系统内固定术治疗的临床效果。方法:选取我院2018年5月-2020年12月收治的82例脊柱胸腰段椎体骨折患者为研究对象,采用随机排列法分为对照组(保守治疗组)和观察组(手术治疗组),每组各41例。其中对照组患者给予保守治疗,即要求患者卧床休息2-3个月,在其背部放置软枕,加强腰背肌的功能锻炼等。观察组患者则给予后路切开骨折复位钉棒系统内固定术治疗。比较2组入院时、伤后3个月和伤后12个月时椎体前缘高度、Cobb角、视觉模拟疼痛评分(VAS)、功能障碍指数评分和生活质量评分的差异,观察患者的治疗效果。结果:2组入院时椎体前缘高度和Cobb角大小对比无明显差异(P>0.05)。伤后3个月和12个月,观察组椎体前缘高度均高于对照组,Cobb角小于对照组(P<0.05),且观察组伤后3个月和12个月的椎体前缘高度均高于本组入院时高度,Cobb角小于本组入院时的大小(P<0.05),但对照组不同阶段椎体前缘高度和Cobb角大小比较无明显差异(P>0.05);2组入院时疼痛评分、功能障碍指数评分和生活质量评分对比无明显差异(P>0.05)。伤后3个月和12个月,观察组疼痛评分、功能障碍指数评分均低于对照组,生活质量评分高于对照组(P<0.05),且2组伤后3个月和12个月的疼痛评分和功能障碍指数均低于本组入院时评分,生活质量评分均高于本组入院时评分(P<0.05);观察组治疗总有效率为90.24%,高于对照组的68.29%(P<0.05)。结论:与保守治疗相比,后路切开骨折复位钉棒系统内固定术治疗脊柱胸腰段椎体骨折患者,可以在促进椎体高度恢复的同时重建脊椎的稳定性,有效减轻患者的疼痛症状,促进患者脊椎功能恢复的同时提高患者的生活质量,临床治疗优势更加突出。Objective:To discuss the clinical effect of open reduction and screw-rod system fixation via posterior approach in treating the spinal and thoracolumbar vertebral fracture.Methods:82 spinal and thoracolumbar vertebral fracture patients treated from May 2018 to December 2020 in our hospital were chosen as research subjects.According to random permutation method,patients were divided into conservative group(41 cases)and surgical group(41 cases).The conservative group received the conservative treatment,namely staying in bed for 2-3 months,placing the soft pillow in the back and strengthening the lumbar spinal muscle function exercises,etc.The surgical group received the open reduction and screw-rod system fixation via posterior approach.Upon admission,after 3m and 12m of injury,the anterior vertebral height,Cobb angle,visual analogue scale(VAS)scores,dysfunction index and life quality scores were compared.Results:Upon admission,the anterior vertebral height and Cobb angle between groups were not significantly different(P>0.05);after 3 m and 12m of treatment,the anterior vertebral height in surgical group was higher than conservative group,but Cobb angle was smaller than conservative group(P<0.05);after 3 m and 12m of treatment,the anterior vertebral height for two groups was higher than that upon admission,but Cobb angle was smaller than that upon admission(P<0.05);in the different treatment stages,the anterior vertebral height and Cobb angle in the conservative group were not significantly different(P>0.05);upon admission,pain,dysfunction index and life quality scores between groups were not significantly different(P>0.05);after 3 m and 12m of treatment,pain and dysfunction scores in surgical group were lower than conservative group,but life quality scores were higher than conservative group(P<0.05);after 3 m and 12m of treatment,pain and dysfunction scores for two groups were lower than those upon admission,but life quality scores were higher than those upon admission(P<0.05);the total effective rate in surgical

关 键 词：脊柱胸腰椎段骨折 后路切开骨折复位钉棒系统内固定术 椎体前缘高度 COBB角 疼痛评分 

分 类 号：R683.2[医药卫生—骨科学]