【摘要】 目的探讨过伸牵引弹性按压联合经皮椎弓根螺钉内固定术治疗胸腰椎骨折的临床效果。方法选择单节段胸腰椎骨折患者97例,按治疗方法不同分为观察组48例、对照组49例。对照组采用经皮椎弓根螺钉内固定术治疗,观察组采用过伸牵引弹性按压联合经皮椎弓根螺钉内固定术治疗。比较两组手术时间、术中出血量、下地活动时间、住院时间,术前、术后1天、术后6个月疼痛视觉模拟评分(VAS)、伤椎矢状位后凸Cobb’s角和椎体前缘高度百分比,以及术前和术后6个月Oswestry功能障碍指数(ODI)。结果两组手术时间、术中出血量、下地活动时间和住院时间比较差异均无统计学意义(P均> 0. 05)。两组术后1天和术后6个月VAS、伤椎矢状位后凸Cobb’s角较术前均明显降低,伤椎椎体前缘高度百分比较术前均明显升高,但观察组术后变化更明显(P均<0. 05);两组术后1天与术后6个月上述指标变化不明显(P均> 0. 05)。两组术后6个月ODI较术前均明显降低,但观察组术后6个月变化更明显(P均<0. 05)。结论过伸牵引弹性按压联合经皮椎弓根螺钉内固定术治疗胸腰椎骨折临床效果较好,不仅能促使骨折复位,还能提升患者生活能力。更多还原

【Abstract】 Objective To investigate the clinical effect of hyperextension traction elastic pressure combined with percutaneous pedicle screw fixation in treatment of thoracolumbar fracture. Methods According to different treatment methods,97 patients with single segment thoracolumbar fracture were divided into the observation group of 48 cases and the control group of 49 cases. The patients in the control group were treated with percutaneous pedicle screw fixation,while patients in the observation group were treated with hyperextension traction elastic pressure combined with percutaneous pedicle screw fixation. The operation time,intraoperative bleeding volume,ambulation time,hospitalization time,visual analogue scale of pain( VAS) before operation,1 day after operation and 6 months after operation,Cobb’s angle of sagittal kyphosis of injured vertebrae and vertebral height,Oswestry dysfunction index( ODI) before and 6 months after operation was compared between the two groups. Results There were no significant differences in the operation time,intraoperative bleeding volume,ambulation time or hospitalization time between the two groups( all P > 0. 05). The VAS and Cobb’s angle of sagittal kyphosis of the injured vertebrae decreased and the vertebral height increased in the two groups at 1 day and 6 months after operation,but the change was more significant in the observation group( P < 0. 05). The ODI of the two groups at 6 months after operation was significantly lower than that before operation,and the ODI of the observation group at 6 months after operation was significantly lower than that of the control group( P < 0. 05). Conclusion Hyperextension traction elastic pressure combined with percutaneous pedicle screw fixation for thoracolumbar fracture has a good clinical effect,which can not only promote fracture reduction,but also improve the life ability of patients.更多还原