【摘要】 目的比较后路单运动单元与双运动单元椎弓根钉内固定治疗胸腰段脊柱骨折的临床疗效。方法回顾性分析自2008-01—2016-01诊治的62例胸腰段脊柱骨折,采用单运动单元椎弓根钉内固定治疗32例(观察组),采用双运动单元椎弓根钉内固定治疗30例(对照组)。比较2组切口长度、手术时间、术中出血量,术后3 d及术后1年ODI指数,以及术后1周及末次随访时伤椎前缘高度比值、伤椎Cobb角。结果 62例均获得随访,随访时间平均14(12~18)个月。2组术后ODI指数、伤椎前缘高度比值、伤椎Cobb角均较术前明显改善,差异有统计学意义(P<0.05)。与对照组比较,观察组切口长度更短,手术时间及术中出血量更少,术后3 d及术后1年ODI指数更低,差异有统计学意义(P<0.05)。2组术后1周及末次随访时伤椎前缘高度比值、伤椎Cobb角比较差异无统计学意义(P>0.05)。结论经伤椎单运动单元椎弓根钉内固定治疗胸腰段脊柱骨折固定节段少、创伤小,术后对患者生活质量影响小,同时又可提供与短节段固定相当的稳定性,疗效满意。更多还原

【Abstract】 Objective To compare the clinical curative effect between posterior mono-segment pedicle instrumentation with short-segment pedicle instrumentation in the treatment of thoracolumbar fractures. Methods Sixty two cases of thoracolumbar spine fractures treated from January 2008 to January 2016 were retrospectively analyzed. Among them, 32 cases were treated by mono-segment pedicle instrumentation(observation group) while 30 cases were treated by short-segment pedicle instrumentation(control group). The incision length, operative time, intraoperative blood loss, postoperative three days and one year ODI index were compared between the two groups. And the height ratio of the injured vertebral leading edge and the Cobb angle of injured vertebrae were compared between the two groups at one week after operation and the last follow-up.Results All 62 cases were followed up, and the average follow-up time was 14(12-18) months. The ODI index, the height ratio of the injured vertebral leading edge and the Cobb angle of the injured vertebra were significantly improved after operation in the two groups, the difference was statistically significant(P <0.05). Compared with the control group, the length of incision in the observation group was shorter, the operative time and intraoperative blood loss were less, the ODI index was lower at three days after operation and one years after operation, the difference was statistically significant( P <0.05). There were no significant differences in the height ratio of the injured vertebral leading edge and the Cobb angle of the injured vertebra in the two groups at one week after operation and the last follow-up(P >0.05). Conclusion The treatment of thoracolumbar spine fractures with mono-segment pedicle instrumentation has less fixation and less trauma, it has little effect on the quality of life to patients after operation, and it can provide the stability equivalent to the short-segment pedicle instrumentation. The effect is satisfactory.更多还原