【摘要】 目的探讨重度不稳定型胸腰椎骨折采取后路短节段经伤椎椎弓根螺钉固定治疗的疗效。方法 2016年3月—2017年3月深圳市宝安区沙井人民医院脊柱外科收治的82例重度不稳定型胸腰椎骨折患者,根据治疗方式分为传统跨伤椎固定41例(跨伤椎组)与后路短节段经伤椎椎弓根螺钉固定41例(经伤椎组),比较两组患者手术时间、术中出血量、术后下地时间、伤椎相对高度、伤椎相邻椎Cobb角、VAS评分及ODI评分。结果手术时间及术中出血量,两组比较差异有统计学意义(P<0.05);两组术后下地时间比较差异无统计学意义(P>0.05);两组术后1年伤椎相对高度、伤椎相邻椎Cobb角较术前均显著改善,但经伤椎组伤椎复位率及Cobb角矫正度显著优于跨伤椎组(P<0.05);术后1年,两组患者VAS评分及ODI评分相比于术前均显著降低。而相比跨伤椎组,经伤椎组患者上述评分降低幅度更显著(P<0.05)。结论重度不稳定型胸腰椎骨折采取后路短节段经伤椎椎弓根螺钉固定治疗,治疗效果确切,具有临床推广价值。更多还原

【Abstract】 Objective To investigate the effect of short segmental posterior pedicle screw fixation for severe unstable thoracolumbar fractures. Methods Totally 82 patients with severe unstable thoracolumbar fractures were enrolled in our hospital from Mar. 2016 to Mar. 2017.They were divided into control group(n=41,treated with traditional transpedicular fixation) and observation group(n=41,treated with posterior short-segment across pedicle screw fixation) according to different treatment. The operative time,intraoperative blood loss,postoperative time to the ground,the relative height of vertebral injuries,Cobb’s angle of the adjacent injured vertebrae,VAS score and ODI score were compared between the two groups Results Relative height of injured vertebrae and Cobb’s angle of adjacent vertebrae were significantly improved after operation in both groups,but reduction rate and correction degree of Cobb’s angle in the observation group were significantly better than those in control group(P<0.05).The operation time and bleeding volume were significantly shorter in the observation group than in the control group(P<0.05). There was no significant difference in postoperative grounding time(P>0.05).One year after treatment,the VAS score and ODI score of the two groups were significantly lower than before treatment,but compared with the control group,the score of the observation group decreased more significantly(P<0.05). Conclusion Severe unstable thoracolumbar fractures can be effectively treated with posterior short-segment pedicle screw fixation.The treatment effect is definite and has clinical value.更多还原