胸腰椎爆裂型骨折68例治疗分析

A Treatment Analysis of Thoracolumbar Burst Fractures for 68 Cases

68例胸腰段(T_(12)～L_2)爆裂型骨折行手术或非手术治疗。A组(手术组)44例,使用Dick钉固定,B组(非手术组)24例,卧木板床及石膏支具固定。A组后凸畸形(Cobb)平均术前15.9°,随访8.6°;B组则分别为10.7°、13.3°。CT扫描椎管狭窄程度前者分别为40.8％、25.3％;后者26.0％、20.7％。脊髓神经功能Frankel分级,A组术前A级7例、B级1例、C级7例、D级12例,随访A级1例、C级1例、D级6例;B组伤后B级2例、D级1例,随访D级3例。疼痛程度两组无明显差异。B组损伤程度较轻,两组不能作统计学对比。提出早期手术治疗的指征。

Sixty - eight cases with acute thoracolumbar (T11 ~ L2 ) burst fractures were operatively or conservatively treated and their effect were analysed. Forty - four patients had surgical treatment by Dick System in A group and 24 pa-tients had nonsurgical treatment such as bedrest plaster brace in B group. Kyphosis angle measured with Cobb method was 15.9°before the operation and 8.6°at the final follow-up study in A group, however it was 10.7° and 13.3° in B group.CT scan revealed the degree of spinal stenosis. It was 40.8% before the operation and 25.3% at the follow- up study in A group and 26% and 20.7% in B group.Spinal cord function was evaluated according to the method of Frankel.There were 7 cases (A)、1 case (B)、7 cases (C)、12 cases (D) at the preoperation and 1 case (A), 1 case (C)、6 cases (D) at the follow- up in A group. In B group there were 2 case (B), 1 case (D) after the injury and 3 cases (D) at the follow-up.The degree of pain had no significant difference and the severity of injury in B group is slighter than that of injury in A group. So the both groups can't be compared with each other statistically. According to the results of follow-up study, the authors introduce the indication for early surgical treatment.