摘要
目的探讨伤椎单侧固定与双侧固定后路短节段内固定术治疗胸腰椎骨折的效果。方法将2013年6月至2015年6月我科收治的73例胸腰椎骨折患者作为研究对象,其中48例附加伤椎双侧置钉的6钉固定患者作为6钉固定组,25例附加伤椎单侧置钉的5钉固定患者作为5钉固定组,随访时间平均24.6个月,对比分析2组患者在手术时间、术中出血量、术后引流量、住院时间和费用、矢状位后凸Cobb’s角、伤椎后凸角、椎体前缘高度、术后矫正度丢失情况、疼痛VAS评分、ODI评分的差异。结果2组患者的手术时间、住院费用比较差异有统计学意义(P<0.01)。2组患者术前与术后患者的矢状位后凸Cobb’s角、伤椎后凸角、椎体前缘高度比较差异有统计学意义(P<0.05),2组末次随访时矫正度的丢失情况比较差异无统计学意义(P>0.05)。结论伤椎单侧内固定技术能够显著矫正胸腰椎骨折的后凸畸形,达到伤椎双侧固定后路短节段内固定术的临床效果,且较伤椎双侧内固定术能够明显减少手术时间和住院费用。
Objective To assess the operation resuhs of unilateral and bilateral short-segment pedicle screw fixation combined with in- termediate screws in thoracolumbar fractures. Methods A total of 73 patients with thoracolumbar fracture were included in our study. Among the 73 patients, 48 cases were treated by bilateral short-segment pedicle screw fixation and the other 25 cases were treated by unilateral short- segment pedicle screw fixation, with a mean follow-up of 24.6 months. Surgical time, surgical blood loss, surgical draining loss, hospital stays, hospitalization cost, Cobb＇ s angle, kyphosis of the vertebral body, anterior height of the fracture vertebral body, VAS and ODI scores between the two groups were compared. Results There were significant differences in the surgical time and hospitalization cost between two groups （ P 〈 0.01 ）. The differences in the Cobb＇ s angle, kyphosis of the vertebral body, and anterior height of the fracture vertebral body before and after surgery between two groups were all significant（ P 〈 0.05 ）. There was no significant difference in the loss of the correction at the last fol- low-up between the two groups（P 〉 0.05）. Conclusion Unilateral short-segment pedicle screw fixation combined with intermediate screws can significantly correct the kyphosis and achieve the clinical effect of bilateral short-segment pediele screw fixation technique. Meanwhile, the unilateral short-segment pedicle screw fixation technique can significantly reduce the surgical time and hospitalization cost,whlch is an ef- fective method for thoracolumbar fracture.
出处
《局解手术学杂志》
2017年第1期22-25,共4页
Journal of Regional Anatomy and Operative Surgery
基金
机器人学国家重点实验室开放课题(2014-012)
美捷登青年科学家研究基金课题(MJR20150013)
中国贫血临床诊疗青年医师科研基金课题(LIM-SS-16001)
辽宁省博士科研启动基金课题(201601389)
关键词
脊柱
胸腰椎骨折
椎弓根螺钉
伤椎固定
单侧
双侧
spine
thoracolumbar fractures
pedicle screw
fractured vertebra fixation
unilateral
bilateral
