摘要
目的探讨伤椎植钉曲度矫正在胸腰椎压缩骨折复位术的效果。方法胸腰椎压缩骨折患者52例,随机分为两组,常规组26例单纯行后路钉棒复位内固定,实验组26例行后路钉棒复位内固定、伤椎植入椎弓根螺钉C臂X线机下进行曲度矫正。比较两组腰背痛VAS评分和ODI评分,测量和计算脊柱曲度Cobb角、伤椎椎体高度百分比及椎间隙高度;比较内固定系统松动及断裂情况,对脊髓损伤分级进行评估。结果两组比较,实验组术后末次随访时VAS和ODI评分均优于常规组(P<0.01或P<0.05);术后即刻两组Cobb角、伤椎椎体高度百分比及椎间隙高度比较无统计学差异(P>0.05),但术后末次随访时实验组较常规组显著改善(P<0.01或P<0.05);实验组术后脊髓功能Frankel分级明显优于常规组(P<0.05),且术后背痛、椎间盘退变加速、钉道松动、钉棒系统断裂及曲度不良等并发症较常规组显著减少(P<0.01或P<0.05)。结论胸腰椎压缩骨折钉棒复位内固定术中行伤椎植钉曲度矫正后手术疗效较好,术后并发症明显减少,患者脊髓损伤得到显著改善。
Objective To investigate the effect of spinal curvature regulation in posterior internal fixation for thoraeolumbar compression fractures. Methods A total of 52 thoracolumbar compression fracture eases were divided into two groups randomly with 26 cases for each. The conventional group were performed posterior internal fixation with nail-stick system, and the experimental group were performed the same internal fixation and management of spinal curvature correction. The lumbodorsal pained was assessed by visual analogue scales（VAS） and Oswestry disability index（ ODI）, Cobb angle of spinal curvature, involved vertebral height percentage and in- tervertebral space height were calculated, and postoperative complications and Frankel score of nerve function were assessed. Results Both VAS and ODI scores of experimental group were superior to those of conventional group in last follow-up（P 〈0.01 or P 〈0.05） ; The Cobb angle, vertebral height percentage and intervertebral space height has no statistic difference between two groups at immediate time after the operation （ P 〉 O. 05 ）, and those were improved significantly in experimental group than in conventional group （ P 〈 O. O1 or P 〈 0.05 ）. Compare to conventional group, the Frankel score of spinal cord nerve function was obviously better and the complication such as back pain, accelerated disc degeneration, screw channel loosen, internal fixators broken and bad curvature was obviously less in experimental group （ P 〈 O. 05 or P 〈 O. 01 ）. Conclusion Applica- tion of spinal curvature correction in posterior internal fixation is an effective procedure for thoraeolumbar com- pression fracture with advantages as less complication and conspicuous improvement of spinal nerve function.
出处
《中国现代手术学杂志》
2013年第5期364-367,共4页
Chinese Journal of Modern Operative Surgery
关键词
曲度矫正
胸腰椎骨折
骨折固定术
内
curvature eorrection
thoraeolumbar fractures
fracture fixation, internal
