摘要
目的:比较前入路和后入路减压手术对胸腰段脊柱骨折合并脊髓损伤患者的疗效及预后。方法:抽取2010年9月至2019年1月在商丘市第三人民医院进行手术治疗的120例胸腰段脊柱骨折合并脊髓损伤患者为研究对象,按照患者入院编号进行分组,编号为偶数者纳入对照组(n=60),编号为奇数者纳入研究组(n=60)。对照组采用后入路减压手术治疗,研究组采用前入路减压手术治疗。比较两组患者的疗效及预后。结果:研究组治疗总有效率(96.67%,58/60)高于对照组(83.33%,50/60),P<0.05。研究组术中出血量大于对照组,手术时间长于对照组,但住院时间短于对照组(P<0.05)。两组患者术后运动评分、触觉评分、椎体高度、Cobb’s角均较术前升高,且研究组上述指标均优于对照组(P<0.05)。研究组术后有51例患者美国脊髓损伤学会(ASIA)分级较术前提高,对照组有40例患者ASIA分级较术前提高,术后两组ASIA分级改善情况比较差异有统计学意义(P<0.05)。结论:前入路减压手术治疗胸腰段脊柱骨折合并脊髓损伤患者的疗效优于后入路治疗,可以有效促进脊髓功能、椎体高度、Cobb’s角的恢复,预后良好。
Objective:To compare the efficacy and prognosis of anterior approach and posterior approach decompression for thoracolumbar spine fracture with spinal cord injury.Methods:A total of 120 patients with thoracolumbar spinal fractures and spinal cord injury who had surgery in the Shangqiu Third People’s Hospital from September 2010 to January 2019 were selected as the research subjects.According to the admission number,they were divided into control group(n=60,even number)and study group(n=60,odd number).The control group was treated with decompression surgery through a throughposterior approach,and the study group was treated with decompression surgery through an anterior approach.The curative effects and prognosis of the two groups were compared.Results:The total effective rate of the study group(96.67%,58/60)was higher than that of the control group(83.33%,50/60),P<0.05.The intraoperative blood loss of the study group was more than that of the control group,the operation time was longer than that of the control group,but the hospital stay was shorter than that of the control group(P<0.05).After surgery,the themotor scores,tactile scores,vertebral heights and Cobb’s angles of the two groups significantly increased,compared with those before operation,and the above indexes in the study group were better than those in the control group(P<0.05).In the study group,there were 51 patients with American Spinal Injury Association impairment scale(ASIA)grade improved,compared with that before operation(P<0.05);and the ASIA grade of 40 patients in the control group were improved,and the difference was statistically significant(P<0.05).Conclusions:Decompression surgery through an anterior approach is more effective than through a posterior approach in treating patients with thoracolumbar spinal fractures complicated by spinal cord injury.The former can effectively promote the recovery of spinal function,vertebral height and Cobb’s angle,with good prognosis.
作者
李德欣
李涛
张伟涛
Li Dexin;Li Tao;Zhang Weitao(Department of Orthopaedics,Shangqiu Third People's Hospital,Shangqiu 476000,China;Department of Orthopaedics,Luoyang Orthopaedic-Traumatological Hospital of Henan Province,Luoyang 471000 China)
出处
《中国实用医刊》
2020年第21期39-42,共4页
Chinese Journal of Practical Medicine
关键词
胸腰段脊柱骨折
脊髓损伤
前入路
后入路
减压手术
Thoracolumbar spinal fracture
Spinal cord injury
Anterior approach
Posterior approach
Decompression surgery
