RF系统与哈氏棒治疗胸腰段不稳定性骨折的对比研究

Treatment of thoracolumbar instable fractures by RF system and Harrington rods: a prospective randomized comparative study of these two methods

目的：比较哈氏棒和ＲＦ系统治疗胸腰段不稳定骨折伴脊髓损伤的复位和疗效。方法：４０例患者随机分为哈氏棒组（１８例）和ＲＦ组（２０例），进行术前后Ｘ片检查及神经功能评定。随访时间１２～４８个月，平均３２个月。结果：两种方法治疗后，脊柱畸形角、前后移位率、压缩椎体高度均较术前有显著改善。ＲＦ治疗组仅在恢复脊柱生理前凸方面比哈氏棒略优。而哈氏棒治疗组平均手术时间比ＲＦ组少。两种治疗方法临床效果相差不显著。结论：哈氏棒及ＲＦ椎弓根系统均是治疗胸腰段脊柱不稳定性骨折伴脊髓损伤的有效方法。两者在复位能力和疗效上差别极小，在临床选择上无理由偏废其一。

Objective:To compare the ability to obtain reduction and improve clinical results of two methods of internal fixation (Harrington rods, reduction fixation system→RF system) in thoracolumbar instable fractures with paraplegia. Methods: Forty patients were randomized into Harrington group (18 cases) and RF group (22 cases) with a mean followup of 25 months (12～36 months). Radiograph and neurologic function evaluation were obtained on admission and postoperatively. Results: Both Harrington instrumentation and RF system were effective on recovering angular deformity, sagittal alignment, and vertebral body height. There was no difference in clinical results between these two methods. The ability of RF to recover angular deformity was little stronger than that of Harrington rods, but Harrington instrumentation was more simple than RF with respect to the operating time. Conclusion: The differences in the ability to obtain the anatomy reduction and stabilization for thoracolumbar instable fractures between these two methods should be small. There seems to be no reason to choose RF or other transpedicle fixator instead of Harrington rods clinically.