摘要
目的:探讨伤椎置钉与不置钉短节段内固定治疗胸腰椎爆裂骨折的疗效。方法:本研究选取了108例胸腰椎爆裂性骨折患者,按照入院时间顺序不同分为两组,不置钉组(52例)行短节段椎弓根螺钉内固定治疗,置钉组(56例)行伤椎置钉联合短节段内固定治疗。观察并记录患者围手术期指标,伤椎前缘高度比,伤椎后缘高度比,Cobb’s角,生活质量及随访12个月期间并发症发生情况,以评价伤椎置钉联合短节段内固定治疗胸腰椎爆裂性骨折疗效。结果:置钉组与不置钉组在术中失血量,手术时间和住院时间上相比,差异没有统计学意义;与术前相比,术后两组伤椎前缘高度比,伤椎后缘高度比均明显提高,Cobb’s角明显下降,且置钉组与不置钉组在伤椎高度比和Cobb’s角上相比,差异具有明显的统计学意义;术后6个月,两组SF-36各项得分均明显升高,置钉组在仅躯体疼痛这一项,评分明显高于不置钉组。随访12个月期间,两组并发症发生率比较,差异没有统计学意义。结论:综上所述,伤椎置钉联合短节段内固定治疗胸腰椎爆裂性骨折,固定方式更符合生物力学稳定性,能恢复并维持伤椎高度,改善患者生活质量,减少术后后凸畸形,值得临床推广使用。
Objective Discuss the efficacy of injury vertebral and no injury vertebral pedicle screw fixation in the treatment of thoracolumbar burst fracture.Methods In this study,108 patients with thoracolumbar burst fracture were selected,they were divided into two groups according to the sequence of admisson time.The no injury vertebral pedicle group(52 cases)was given short segment pedicle screw fixation.The injury vertebral pedicle group(56 cases)was given injury vertebral pedicle combined with short segment pedicle screw fixation.The efficacy of injury vertebral and no injury vertebral pedicle screw fixation in the treatment of thoracolumbar burst fracture was evaluated by perioperative parameters,vertebral height ratio,the Cobb's angle and complications during 12 months follow-up.Results There were no statistical significance on bleeding volume,surgery time and hospitalization between two groups.Compare with the values before sugery,the height ratio of injured vertebra in two groups were increased.The Cobb's angle were decreased.There were statistical significance on Cobb's angle and height ratio of injured vertebra between two groups.Six months after surgery,two groups of SF-36 scores were significantly higher.On the body pain,the scores of injury vertebral pedicle group were higher than that of the no injury vertebral pedicle group.There were no statistical significanec on the rest of the items between two groups.During 12 months follow-up,there were no statistical significance on complications between two groups.Conclusion In summary,the internal fixation mode of injury vertebral pedicle combined with short segment pedicle screw fixation was more suitable for the biomechanical stability.The surgery could fix and maintain the height of injury vertebral,improve the quality of life and reduce the convex deformity.It was worthy of clinical use.
出处
《湖南师范大学学报（医学版）》
2017年第2期97-100,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
胸腰椎爆裂性骨折
伤椎置钉
不置钉
生活质量
椎弓根螺钉
thoracolumbar burst fracture
injury vertebral pedicle
no injury vertebral pedicle
quality of life
pedicle screw
