摘要
目的探索前后路手术治疗胸腰椎爆裂性骨折的临床效果及特点。方法将2013-08-2015-08期间于我院治疗的70例胸腰椎爆裂性骨折患者选为研究对象,均于受伤后8-12 h入院,根据手术方式不同将患者分为两组,即前路组(21例)和后路组(49例),观察两组手术情况及术后恢复情况并进行组间比较。结果前路组和后路组患者术后伤椎前缘高度、伤椎后缘高度及后凸Cobb角与术前比较均有明显改善(P<0.05),但两组间比较差异无统计学意义(P>0.05)。后路组患者手术时间(129.43±10.23)min、术中出血量(287.43±13.23)ml、术后引流量(145.32±10.20)ml与对照组比较均明显减少(P<0.05)。后路组患者植骨融合率(53.04±6.44)%、椎管清除率(55.73±4.83)%与前路组比较明显减少,而并发症发生率8.16%与对照组比较明显降低,组间差异均有统计学意义(P<0.05)。结论前后路手术治疗胸腰椎爆裂性骨折均能取得显著疗效,但后路手术治疗植骨融合、椎管清除效果不及前路手术,但手术创伤小、术中出血少,因此临床应根据患者病情选择合适的手术方式,以期获得最佳治疗效果。
Objective To explore the clinical effect and characteristics of anterior and posterior surgical treatment for thoraeolumbar burst fractures. Methods 70 cases with thoracolumbar spine from August 2013 to August 2015 in our hospital were chosen in the study. All the patients were admitted during the treatment of burst fractures 8-12 h, the patients were divided into the anterior group （21 cases） and posterior group （49 cases）. The surgery and the postoperative recovery were compared between the two groups. Results The postoperative anterior vertebral height, posterior vertebral height and kyphosis Cobb angle were significantly improved compared with before operation （P〈0.05）, but there was no significant difference between the two groups （P〉0.05）. The operative time, amount of bleeding during operation, postoperative drainage of posterior group were （129.43±10.23） rain, （287.43±13.23） ml, （145.32±10.20）, which were significantly lower than those of the control group （P〈0.05）. The bone graft fusion rate, spinal clearance rate of posterior group were （53.04 ±6.44）%, （55.73 ±4.83）%, which were significantly lower than those of anterior group. The incidence rate of eomplication of posterior group was 8.16%, which was significantly lower than that of control group,the difference was statistically significant （P〈0.05）. Conclusion The anterior and posterior surgical in the treatment of thorac：olumbar burst fracture can achieve significant effect, but the bone fllsion and vertebral canal removal of posterior surgical treatment are not better than anterior surgery, but it has less surgical trauma, less bleeding, so the clinical appropriate surgical approach should be selected according to the condition of patients, in order to get the best treatment effect.
作者
张健
ZHANG Jian(Department of Spinal Surgery, People＇s Hospital of Xiangtan County, Xiangtan, Hunan 411200, China)
出处
《颈腰痛杂志》
2017年第4期371-373,共3页
The Journal of Cervicodynia and Lumbodynia
关键词
前路手术
后路手术
胸腰椎爆裂性骨折
临床效果
anterior surgery
posterior approach
thoracolumbar burnt fracture
clinical effect
