经伤椎椎弓根螺钉复位内固定治疗单节段胸腰椎骨折的临床疗效观察(1)
[摘要] 目的 探讨经伤椎椎弓根螺钉复位内固定治疗胸腰椎骨折的临床疗效。 方法 整群选取并回顾性分析2009年3月—2016年3月该院收治的49例单节段胸腰椎骨折手术患者的临床资料，按照治疗方式分成两组，观察组23例行经伤椎椎弓根螺钉复位内固定，而采取传统跨伤椎短节段固定患者26例作为对照组。观察两组患者手术前后前后伤椎高度的恢复情况，随访观察Cobb角丢失情况。 结果 手术前后观察组和对照组前柱高度变化分别为(40.21±4.83)%和(19.82±3.65)%，Cobb角变化分别为(9.79±3.27)°和(5.02±2.12)°，观察组明显优于对照组，差异具有统计学意义(P<0.05)。术后3个月时观察组和对照组Cobb角丢失分别为(1.62±0.42)°和(5.59±1.23)°，6个月时分别为(2.38±0.42)°和(7.65±1.83)°，差异具有统计学意义(P<0.05)。术后1年时观察组Cobb角无继续丢失，对照组丢失(8.46±2.08)°。 结论 应用伤椎椎弓根螺钉技术治疗单节段胸腰椎骨折临床效果更好，固定稳定性好，能够保证患者早日下地活动，值得临床推广。
[关键词] 胸腰椎骨折；伤椎固定；疗效
[中图分类号] R68 [文献标识码] A [文章编号] 1674-0742(2016)11(a)-0005-03
[Abstract] Objective To investigate the clinical effect of the injured vertebral pedicle screw reduction and internal fixation in treatment of single segment thoracolumbar fractures. Methods Group selection and retrospectively analysis the clinical data of 49 cases of patients with single segmental thoracolumbar fractures from March 2009 to March 2016， including 23 patients who received through injured vertebral pedicle screw reduction and internal fixation as the observation group， 26 patients who received the short segment fixation traditional across the injured vertebra as the control group. Observed the forward the vertebral height recovery degree of the injured vertebra of the two groups before and after surgery. Follow-up and observed the lost situation of the Cobb Angle. Results The anterior column height change respectively was (40.21±4.83) % and (19.82±3.65) %， Cobb Angle respectively was (9.79±3.27) ° and (5.02±2.12) °， the observation group was better than the control group， had statistically significant difference (P < 0.05).The Cobb Angle lost of the observation group and control group 3 months after surgery respectively was (1.62±0.42)°and (5.59±1.23)°， 6 months after surgery respectively was(2.38±0.42)°and (7.65±1.83)°， the observation group was less than the control group， had statistically significant difference(P < 0.05). The Cobb Angle of the observation group 1 years after surgery no continue to lose， the control group lost(8.46±2.08)°. Conclusion Application of pedicle screw technique in the treatment of single segment thoracolumbar fractures has better clinical results， can ensure the patient's early activities， it is worth clinical promotion.
[Key words] Thoracolumbar fractures； Injured vertebral fixation；The curative effect
胸腰椎骨折是指由于外力造成胸腰椎骨質连续性的破坏，是最常见的脊柱损伤。临床治疗单节段胸腰椎骨折的手术多由后路经伤椎上下椎体椎弓根钉棒系统给予撑开复位内固定[1-3]。有学者尝试行经伤椎椎弓根螺钉复位内固定治疗单节段胸腰椎骨折，但其必要性及适应症等问题尚存在一定争议[4]。因此，回顾性分析2009年3月—2016年3月该院收治的49例单节段胸腰椎骨折手术患者的临床资料，报道如下。 (徐瑞亮)
[关键词] 胸腰椎骨折；伤椎固定；疗效
[中图分类号] R68 [文献标识码] A [文章编号] 1674-0742(2016)11(a)-0005-03
[Abstract] Objective To investigate the clinical effect of the injured vertebral pedicle screw reduction and internal fixation in treatment of single segment thoracolumbar fractures. Methods Group selection and retrospectively analysis the clinical data of 49 cases of patients with single segmental thoracolumbar fractures from March 2009 to March 2016， including 23 patients who received through injured vertebral pedicle screw reduction and internal fixation as the observation group， 26 patients who received the short segment fixation traditional across the injured vertebra as the control group. Observed the forward the vertebral height recovery degree of the injured vertebra of the two groups before and after surgery. Follow-up and observed the lost situation of the Cobb Angle. Results The anterior column height change respectively was (40.21±4.83) % and (19.82±3.65) %， Cobb Angle respectively was (9.79±3.27) ° and (5.02±2.12) °， the observation group was better than the control group， had statistically significant difference (P < 0.05).The Cobb Angle lost of the observation group and control group 3 months after surgery respectively was (1.62±0.42)°and (5.59±1.23)°， 6 months after surgery respectively was(2.38±0.42)°and (7.65±1.83)°， the observation group was less than the control group， had statistically significant difference(P < 0.05). The Cobb Angle of the observation group 1 years after surgery no continue to lose， the control group lost(8.46±2.08)°. Conclusion Application of pedicle screw technique in the treatment of single segment thoracolumbar fractures has better clinical results， can ensure the patient's early activities， it is worth clinical promotion.
[Key words] Thoracolumbar fractures； Injured vertebral fixation；The curative effect
胸腰椎骨折是指由于外力造成胸腰椎骨質连续性的破坏，是最常见的脊柱损伤。临床治疗单节段胸腰椎骨折的手术多由后路经伤椎上下椎体椎弓根钉棒系统给予撑开复位内固定[1-3]。有学者尝试行经伤椎椎弓根螺钉复位内固定治疗单节段胸腰椎骨折，但其必要性及适应症等问题尚存在一定争议[4]。因此，回顾性分析2009年3月—2016年3月该院收治的49例单节段胸腰椎骨折手术患者的临床资料，报道如下。 (徐瑞亮)