前后路联合及单纯后路治疗成人胸腰段脊柱骨折疗效比较

Comparison of Anterior and Posterior Approaches and Simple Posterior Approaches in the treatment of Thoracolumbar Spinal Fractures in Adults

目的:研究前后联合入路及单纯的后路治疗成人胸腰段脊椎骨折的疗效。方法:选取我院2016年5月至2018年8月我院收治的成人胸腰段脊椎骨折患者60例作为研究对象,根据患者手术治疗方式的不同将其分为A组32例,B组28例,B组采用单纯后路治疗,A组在B组基础上采用前路联合后路治疗。观察两组患者治疗后临床疗效,对两组患者治疗前后运动功能与触觉功能评分,伤椎高度、Cobb角度进行观察记录。结果:治疗后两组患者显效、有效、无效相较差异具有统计学意义(P<0.05);治疗总有效率A组显著高于B组,差异具有统计学意义(P<0.05)。治疗后两组运动功能、触觉功能评分显著高于治疗前,但A组治疗后上述评分显著高于B组,差异具有统计学意义(P<0.05);治疗后A组、B组患者伤椎高度显著高于治疗前,治疗后A组显著高于B组,差异具有统计学意义(P<0.05);Cobb角度治疗后两组患者显著下降,与治疗前相较差异具有统计学意义(P<0.05);但A组显著低于B组,差异具有统计学意义(P<0.05)。A组手术时间、术中出血量显著高于B组,差异具有统计学意义(P<0.05);住院时间两组相较,差异无统计学意义(P>0.05)。结论:前后路联合治疗成人胸腰段脊椎骨折具有显著效果。

Objective: To study the effect of combined anterior and posterior approaches and simple posterior approaches in the treatment of adult thoracolumbar vertebral fractures. Methods: 60 adult patients with thoracolumbar vertebral fracture admitted to our hospital from May 2016 to August 2018 were selected as the research objects. According to the different surgical treatment methods, they were divided into group A(32 cases), group B(28 cases), group B(28 cases), group B(simple posterior treatment), group A(anterior combined posterior treatment) on the basis of group B. To observe the clinical efficacy of the two groups after treatment, the motor function and tactile function score, vertebral height and Cobb angle of the two groups before and after treatment were observed and recorded. Results: After treatment, there were significant differences in marked, effective and ineffective effects between the two groups(P<0.05), and the total effective rate of group A was significantly higher than that of group B(P<0.05). After treatment, the scores of motor function and tactile function in two groups were significantly higher than those before treatment, but after treatment, the scores in group A were significantly higher than those in group B, with statistical significance(P<0.05); after treatment, the height of injured vertebrae in group A and group B was significantly higher than that before treatment, and after treatment, the scores in group A were significantly higher than that in group B, with statistical significance(P<0.05); after treatment, the Cobb angle in two groups was significantly decreased, with treatment. There was significant difference before treatment(P<0.05), but group A was significantly lower than group B(P<0.05).The operative time and intraoperative blood loss in group A were significantly higher than those in group B(P<0.05), but there was no significant difference in hospitalization time between the two groups(P>0.05). Conclusion: The combined treatment of thoracolumbar spine fracture by anterior and posterior approach has significant effect.