摘要
目的比较分析保留与不保留后柱稳定结构的2种后路减压方法治疗胸腰椎新鲜爆裂骨折并神经损伤的临床疗效。方法回顾性分析自2008-07—2012-06诊治的191例胸腰椎新鲜爆裂骨折并神经损伤,按减压方式分为2组:89例保留后柱稳定结构减压组(A组)与102例不保留后柱稳定结构减压组(B组)。结果术后进行平均12个月随访。随访时A组VAS评分(1.0±0.5)分,B组(2.5±0.8)分,差异有统计学意义(P<0.05)。Barthel评分、Frankel分级均有不同程度改善,组间比较差异无统计学意义(P>0.05)。脊柱后凸Cobb角、伤椎前后缘高度、椎管狭窄率在术后均有明显改善,但B组在椎体前缘高度、脊柱后凸Cobb角的矫形丢失情况较明显,丢失率分别达(15.92±5.67)%、(8.58±2.14)%。随访时2组间椎体前缘高度、脊柱后凸Cobb角差异有统计学意义(P<0.05)。结论保留后柱稳定结构减压术式具有手术创伤小、椎管干扰小、减压充分、术后脊柱稳定性好的优点,值得推广。
Objective To evaluate the clinical effects of retained and removed posterior column to vertebral canal decompression in the treatment of thoracolumbar fresh burst fracture with nerve injury. Methods A total of 191 cases of thoracolumbar fresh burst fracture with nerve injury were treated in our hospital from July 2008 to June 2012. They were divided into two groups by decompression range： in the group A, 89 case decompression were retained the posterior column.And 102 cases were removed the posterior column in group B. Results With an average of 12 months follow-up after surgery, the VAS score was（1.0±0.5） in group A and（2.5±0.8） in group B, difference was statistically significant（P 〈0.05）.Barthel score, Frankel classification were improved to varying degrees, there was no statistically significant difference between the two groups（P〉 0.05）. Kyphosis Cobb＇s angle, anterior and posterior height of vertebral body, rate of stenosis were obviously improved after surgery, but group B in anterior height and Cobb＇s angle were decreased obviously, loss rate were（15.92±5.67）% and（8.58±2.14）% respectively. Difference between follow-up anterior height and Cobb＇s angle in two groups were statistically significant（P 〉0.05）. Conclusion There are advantages in decompression surgery of retained posterior column stability： minimal invasive, little interference to the spinal canal, sufficient decompression, nice spinal stability after operation, and it is worth promoting.
出处
《中国骨与关节损伤杂志》
2015年第1期17-20,共4页
Chinese Journal of Bone and Joint Injury
基金
中山市医学科研基金项目(2013A020320)
关键词
胸腰椎骨折
后柱稳定性
减压
神经损伤
Thoracolumbar fracture
Stability of the posterior column
Decompression
Nerve injury
