摘要
目的:探讨用后路内固定融合术治疗脊柱胸腰段骨折的临床效果。方法:对2010年1月~2013年1月期间我院收治的86例脊柱胸腰段骨折患者的临床资料进行回顾性研究。我院按照手术入路的不同,将这86例患者分为观察组和对照组,每组各有43例患者。我们对对照组的患者采用前路内固定融合术进行治疗,对观察组的患者采用后路内固定融合术进行治疗。治疗结束后,比较两组患者的治疗效果。结果:经过治疗,观察组患者手术的成功率为93.02%,对照组患者手术的成功率为76.74%。观察组患者手术的成功率明显高于对照组患者,二者相比差异具有显著性(P<0.05)。观察组患者并发症的发生率为9.30%,对照组患者并发症的发生率为27.91%。观察组患者并发症的发生率明显低于对照组患者,二者相比差异具有显著性(P<0.05)。观察组患者在手术中的出血量、从手术到下床活动的时间和住院的时间分别为(506.9±30.8)ml、(32.1±10.5)h和(5.28±2.26)d;对照组患者在手术中的出血量、从手术到下床活动的时间和住院的时间分别为(821.3±35.6)ml、(73.2±16.7)h和(8.35±1.51)d。观察组患者在手术中的出血量、从手术到下床活动的时间和住院的时间均明显少于对照组患者,二者相比差异具有显著性(P<0.05)。治疗结束后,我院对两组患者均随访1年。两组患者在手术后,其椎体前缘、后缘的高度、后凸Cobb角和椎管的占位率等指标均明显优于手术前,二者相比差异具有显著性(P<0.05)。两组患者在术前和术后的椎体前缘、后缘的高度、后凸Cobb角和椎管的占位率等指标均没有显著差异,二者相比差异无显著性(P>0.05)。结论:用后路内固定融合术治疗脊柱胸腰段骨折具有疗效显著、患者住院的时间短、损伤小、安全系数高等优点。该治疗方法值得在临床上推广使用。
Objective: To investigate the effect of posterior instrumentation and fusion in thoracolumbar fractures. Methods:using the retrospective method,we selected 86 cases of thoracolumbar fracture patients from The Second Affiliated Hospital of Chongqing Medical University between January 2010 to January 2013,according to the treatment were divided the cases into two groups, the control group (43 cases) and the observation group (43 cases),.control group with anterior internal fixation and fusion, the observation groupwith posterior internal fixation and interbody fusion, compare the effect of the two groups. Results: Two groups of patients with operation success rate, complications, bleeding volume were significantly different, with statistical significance (P < 0.05);after 1 year of follow-up, two groups of anterior vertebral height, kyphosis, trailing edge angle Cobb and occupying ratio showed no significant difference (P >0.05). Conclusion: posterior fixation and fusion for treatment of thoracolumbar fracture is a much more simple and easier operation, it can reduce the injury of patients, and the effects of treatment is almost equal to anterior internal fixation fusion, it worths clinical applications.
