胸腰椎爆裂骨折两种后路术式的疗效比较

Comparative Study on the Effects of Posterior Route two Surgical Methods for Thoracolumbar Burst Fractures

目的比较后路两种术式治疗胸腰椎爆裂性骨折的疗效。方法胸腰椎单节段骨折40例,按置钉椎体情况分为传统椎弓根固定组(四钉固定组)和经伤椎椎弓根固定组(六钉固定组),分别从伤椎前缘压缩比、矢状面Cobb角和冠状面Cobb角方面进行评价。结果两组手术前后的伤椎前缘压缩比、矢状面Cobb角和冠状面Cobb角有明显统计学差异(P<0.001),六钉固定组的伤椎前缘压缩比优于四钉固定组(P<0.001)。结论经伤椎椎弓根螺钉内固定可以更好地恢复脊柱生理弯曲及伤椎前缘高度,使骨折块复位,是治疗胸腰椎爆裂性骨折安全可靠的方法。

Objective To evaluate the effects of posterior rout two surgical methods in the treatment of thoracolumbar burst fractures.Methods Forty patients with isolated thoracolumbar vertebra fractures were included in this study.All the pedicles were divided into two groups according to whether the pedicles were fractured.Two groups were comparatively analyzed from three aspects,that is fractured vertebra height compression ratio,the Cobb′s angle on sagittal plan and the Cobb′s angle on coronal plane.Results The fractured vertebra height compression ratio ,the Cobb＇s angle on sagittal plan and the Cobb＇s angle on coronal plane of two groups before and after surgery had significant differences（P〈0. 001 ）. The fractured vertebra height compression ratio and the Cobb＇s angle on sagittal plan of six pedile screw group were obviously better than four pedile screw group（P〈0. 001）. Conclusion Vertebral pedicle screw fixation on fractured vertebrae is a safty and efective therapeutic options to treat the thoracolumbar burst fractures ,which is able to restore the spinal physiological curve and improve the injured vertebral body height.