经伤椎连续固定与跨节段椎弓根螺钉固定治疗胸腰椎爆裂骨折的疗效比较

Comparison of Consecutive Pedicle Screw Fixation & Short-segment Pedicle Screw Fixation for Thoracolumbar Burst Fracture

目的分析比较经伤椎连续与跨节段椎弓根螺钉固定治疗胸腰椎爆裂性骨折的临床疗效。方法对78例胸腰段爆裂骨折分别采用跨节段椎弓根螺钉固定和经伤椎连续椎弓根螺钉固定,分析比较术后并发症发生情况、Cobb角、后凸比率、ODI(Oswestry功能障碍指数)、VAS(视觉模拟分级法)。结果随访12～18周,术前和术后2周两组间Cobb角、后凸比率、ODI、VAS比较差异无统计学意义(P>0.05),但术后6周、12周两组之间差异有统计学意义(P<0.05)。结论与跨节段椎弓根螺钉内固定相比,经伤椎连续固定可以减少后凸畸形以及内固定断裂、术后腰背痛等并发症。

Objective To compare the therapeutic effect and complication of consecutive pedicle screw instrument and short-segment pedicle screw instrument for thoracolumbar burst fracture.Methods A retrospective study was carried out for 78 cases of thoracolumbar burst fracture treated by consecutive pedicle screw instrument or short-segment pedicle screw instrument from 2006 to 2008.The complication and the Cobbs angle and kyphosis ratio and VAS and ODI were measured and compared between two groups.Results All cases were followed up for 12 to 18 months.There were no significant difference（P〉0.05）between the 2 groups in the Cobbs angle and kyphosis ratio and VAS and ODI before surgery and 2 weeks after surgery.But there were significant difference（P〈0.05）between the 2 groups 6 months after surgery and 12 months after surery.Conclusion Consecutive pedicle screw fixation has advantages on the reduction of the failure rate of fixation,kyphosis deformity and low back pain.