【摘要】 目的 探讨经后路椎弓根螺钉内固定术联合伤椎内植骨术治疗脊柱胸腰段骨折的临床效果。方法 选取我院2017年1月至2020年6月收治的160例脊柱胸腰段骨折患者作为研究对象，采用红绿双色球法将其随机分为对照组（80例，经后路椎弓根螺钉内固定术联合外侧植骨融合术）和观察组（80例，经后路椎弓根螺钉内固定术联合伤椎内植骨术）。比较两组的胸腰椎功能恢复效果、椎体影像学参数、脊柱功能及并发症发生情况。结果 观察组的胸腰椎功能恢复优良率高于对照组，差异具有统计学意义（P<0.05）。术前，两组的各项椎体影像学参数比较，差异无统计学意义（P>0.05）；术后1周，观察组的上部、下部Cobb角均小于对照组，伤椎前缘、后缘高度均大于对照组，差异具有统计学意义（P<0.05）。术前，两组的Worter指数及Prolo、Oswestry功能障碍指数（ODI）评分比较，差异无统计学意义（P>0.05）；术后3个月，观察组的Worter指数、ODI评分低于对照组，Prolo评分高于对照组，差异具有统计学意义（P<0.05）。观察组的并发症总发生率低于对照组，差异具有统计学意义（P<0.05）。结论 经后路椎弓根螺钉内固定术联合伤椎内植骨术治疗脊柱胸腰段骨折患者的临床效果显著，可明显促进胸腰椎功能和形态的恢复，减少术后并发症，值得临床推广和应用。更多还原

【Abstract】 Objective To explore the clinical effect of posterior pedicle screw internal fixation combined with bone grafting in injured vertebra in the treatment of spinal thoracolumbar fractures. Methods A total of 160 patients with spinal thoracolumbar fractures admitted in our hospital from January 2017 to June 2020 were selected as the research objects, and the patients were randomly divided into control group(80 cases, posterior pedicle screw internal fixation combined with lateral bone grafting and fusion) and observation group(80 cases, posterior pedicle screw internal fixation combined with bone grafting in injured vertebra) by the red and green double color ball method. The recovery effect of thoracolumbar function, vertebral imaging parameters, spinal function and occurrence of complications were compared between the two groups. Results The excellent and good rate of thoracolumbar function recovery in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05). Before operation, there were no significant differences in the vertebral imaging parameters between the two groups(P>0.05); one week after operation, the upper and lower Cobb angles in the observation group were smaller than those in the control group, the height of the anterior and posterior edges of the injured vertebrae were greater than those in the control group, and the differences were statistically significant(P<0.05). Before operation, there were no significant differences in Worter index, Prolo and Oswestry Disability Index(ODI) scores between the two groups(P>0.05); three months after operation, the Worter index and ODI score in the observation group were lower than those in the control group, the Prolo score was higher than that in the control group, and the differences were statistically significant(P <0.05). The total incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). Conclusion Posterior pedicle screw internal fixation combined with bone grafting in injured vertebra in the treatment of patients with spinal thoracolumbar fractures has a significant clinical effect, it can significantly promote the recovery of thoracolumbar function and morphology, and reduce the postoperative complications, which is worthy of clinical promotion and application.更多还原