陈旧性胸腰段骨折继发后凸畸形前后路手术治疗分析

Comparison analysis of anterior and posterior surgical approaches to old thoracolumbar kyphosis secondary to fracture

目的探讨陈旧性胸腰段骨折继发后凸畸形前后路手术的临床效果。方法对我院2008-2010年收治的20例陈旧性胸腰椎骨折后凸畸形患者,针对不同的情况选择两种不同的手术方式,其中前路手术10例,后路手术10例,比较分析临床效果。结果全部病例均无严重的术中以及术后并发症,术后患者腰背痛及下肢麻木症状缓解或消失,后路手术的手术时间以及术中出血量明显少于前路手术组;前路手术骨融合率明显高于后路手术组;前后路手术脊髓神经功能恢复比较以及术后、术后1年、术后2年的楔变角、后凸角比较差异无统计学意义。结论对陈旧性胸腰椎骨折后凸畸形患者,术前全面评估,有针对性地选择手术方式,可获得良好的临床结果。

Objective To investigate the clinical efficacy of anterior and posterior surgical approaches to old thoracolumbar kyphosis secondary to fracture.Methods 20 cases with old thoracolumbar kyphosis secondary to fracture were enrolledl from 2008-2010,and 10 cases were given anterior surgery,while the others were given posterior surgery.Results All patients had no serious operative and postoperative complications;the low back pain and numbness were disappeared or eased after the surgery.The time and blood loss in posterior surgery was significantly less than that in the anterior group during the surgery;there were no statistically significance in functional recovery of spinal cord,wedge angle,kyphosis angle after 2 years postoperatively between two groups.Conclusion Preoperative comprehensive assessment and targeted selection of surgical approach can achieve good clinical outcomes to the patients with old thoracolumbar kyphosis secondary to fracture.