摘要
目的探讨伤椎置钉手术和后路短节段椎弓根钉内固定术治疗单节段胸腰椎骨折临床效果。方法回顾性分析2013年1月至2015年7月接诊的单节段胸腰椎骨折患者80例,根据手术方式不同将患者分为观察组和对照组,各40例。观察组给予伤椎置钉手术治疗,对照组给予后路短节段椎弓根钉内固定术治疗。比较两组患者治疗手术参数情况以及治疗后的cobb角、椎体压缩百分比、椎管矢状径占位率、视觉疼痛模拟评分(VAS评分)、和欧式功能障碍指数(ODI),对比术后1年内固定失败率情况。结果治疗后,两组手术时间、住院时间以及失血量情况进行比较,差异无统计学意义(P>0.05);观察组cobb角、椎体压缩百分比以及椎管矢状径占位率明显低于对照组(P<0.05)。术后2周、术后3周两组患者VAS评分均有降低,观察组低于对照组(P<0.05);术后1周、术后3周两组患者ODI指数均有降低,观察组低于对照组(P<0.05);观察组术后1年内固定总失败率为2.50%,低于对照组17.50%,差异具有统计学意义(P<0.05)。结论单节段胸腰椎骨折选用伤椎置钉手术治疗,可提高远期固定效果,减少椎体坍塌、内固定失败的发生,缓解术后疼痛,促进患者术后早期康复。
Objective To study the clinical effect of the treatment of single segment thoracolumbar fracture with the operation of the wound vertebra and the posterior segment pedicle screw fixation. Methods 80 cases of single segment thoracolumbar fractures from January 2013 to July 2015 in our hospital were retrospectively analyzed,according to the different surgical methods,the patients were divided into the observation group and the control group,40 cases in each group. The observation group was given the surgical treatment of the injured vertebra,and the control group was treated with posterior short segment pedicle screw fixation. Surgical parameters and Cobb angle after treatment,vertebral compression percentage,spinal canal sagittal diameter occupancy rate,VAS points and ODI index at different time points were compared. The fixed failure rate within one year after operation in the two groups were compared. Results After treatment,operation time,hospitalization time and blood loss of the two groups were compared,the difference was not statistically significant（ P〈0. 05）,and the percentage of Cobb angle,the percentage of vertebral compression and the occupying rate of the sagittal diameter of the vertebral canal in the observation group were significantly lower than those of the control group（ P〈0. 05）. After 2 weeks and 3 weeks operation,the VAS scores of the two groups were reduced,and the observation group was lower than that of the control group（ P〈0. 05）,and after 1 week of operation and 3 weeks after operation,the ODI index decreased in the two groups,and that in the observation group was lower than that in the control group（ P〈0. 05）. And after treatment,the total failure rate in the observation group was 2. 50% less than that of the control group（ 17. 50%） after one year. The difference was statistically significant（ P〈0. 05）. Conclusion Single segment thoracolumbar fractures treated with pedicle screw placement can improve long-term fixation effect,reduce vertebral collapse and failure of internal fixation,relieve postoperative pain and promote early postoperative rehabilitation.
作者
杨益
文俊恩
赵海
温广宇
王隆辉
陈定中
YANG Yi;WEN Jun-en;ZHAO Hai(Department of Orthopaedics,The Second Affiliated Hospital of Hainan Medical University,Haikou Hainan 570311,China.)
出处
《临床和实验医学杂志》
2018年第15期1667-1670,共4页
Journal of Clinical and Experimental Medicine
关键词
胸腰椎骨折
伤椎置钉手术
后路段节段椎弓根钉内固定术
Thoracolumbar fracture
Vertebral pedicle screw surgery
Posterior short segment pedicle screw fixation
