摘要
背景:经后路椎弓根螺钉置入内固定是胸腰椎压缩性骨折常用的修复方式之一,其固定方式又包括长节段固定、短节段固定及经伤椎固定等多种方式。其中经伤椎单节段固定及跨伤椎短节段固定修复胸腰椎骨折的临床疗效尚未明确。目的:比较后路经伤椎与跨伤椎椎弓根螺钉置入内固定修复胸腰椎压缩性骨折的稳定性。方法:回顾性分析46例胸腰椎压缩性骨折患者的临床资料,根据内固定方式分为经伤椎固定组(n=21)和跨伤椎固定组(n=25)。对两组患者的手术时间、术中出血、术中输血、卧床时间,以及伤椎Cobb角、伤椎前缘高度和目测类比评分进行长期随访评价。结果与结论:(1)两组患者在修复治疗过程中,跨伤椎组在手术时间,术中出血和术中输血方面要优于经伤椎组(P<0.05-0.01),经伤椎组在卧床时间上优于跨伤椎组(P<0.01)。(2)Cobb角和伤椎前缘高度方面,两组在治疗前、治疗后和及修复纠正方面差异未见显著性意义,而经伤椎组在末次随访和随访丢失方面要优于跨伤椎组(P<0.05-0.01)。(3)在目测类比评分方面,两组组间比较,治疗前、治疗后差异均无显著性意义,而经伤椎组在末次随访时要优于跨伤椎组,差异有显著性意义(P<0.01)。(4)提示经长期随访两种方式均能获得较满意的修复效果,与跨伤椎组相比经伤椎组在维持脊柱的高度和曲度方面优势更加明显,可更加有效的重建脊柱生理序列并恢复其稳定性,修复后腰背痛也可以得到有效控制。
BACKGROUND： Posterior pedicle screw fixation is a common method for treatment of thoracolumbar compression fractures. The fixation method contains long-segment fixation, short-segment fixation and vertebral fixation. Clinical effects of vertebral fixation and inter-vertebral short-segment fixation for treating thoracolumbar fractures remain unclear. OBJECTIVE： To compare the stability of posterior vertebral fixation and inter-vertebral pedicle screw fixation for treating thoracolumbar compression fractures. METHODS： Clinical data of 46 patients with thoracolumbar compression fractures were retrospectively analyzed. According to the fixation methods, they were divided into the vertebral fixation group（n=21） and inter-vertebral fixation group（n=25）. The operation time, intraoperative bleeding, intraoperative blood transfusion, the time of lying in bed, vertebral Cobb angle, anterior vertebral height and visual analog scores were evaluated for a long time. RESULTS AND CONCLUSION：（1） During repair, in both groups, operation time, intraoperative bleeding and intraoperative blood transfusion were better in the inter-vertebral fixation group than in the vertebral fixation group（P〈0.05-0.01）. The time of lying in bed was better in the vertebral fixation group than in inter-vertebral fixation group（P〈0.01）.（2） No significant difference in Cobb angle and anterior vertebral height was detected before and after treatment and during repair in both groups, but final follow-up and follow-up loss were better in the vertebral fixation group than in inter-vertebral fixation group（P〈0.05-0.01）.（3） No significant difference in visual analog scores was detected before and after treatment in both groups. Visual analog scores were better in the vertebral fixation group than in the inter-vertebral fixation group（P〈0.01）.（4） These results suggested that the two fixation methods obtained satisfactory repair effects in long-term follow-up. The dominance in maintaining the height and curvature of the spine was more obvious in the vertebral fixation group than in the inter-vertebral fixation group. The vertebral fixation can be more effective to reconstruct the spinal physiological sequence and restore its stability. After repair, low back pain can also be effectively controlled.
出处
《中国组织工程研究》
CAS
北大核心
2016年第4期522-528,共7页
Chinese Journal of Tissue Engineering Research
基金
2013年湖北省自然科学基金资助项目(2013CFB269)~~
