两种方法治疗胸腰椎单节段爆裂性骨折的疗效对比分析

Comparative the efficacy of cross-segment pedicle screw fixation and posterior vertebral pedicle screw in treatment of thoracolumbar burst fracture of single-segment

目的分析比较跨节段椎弓根螺钉内固定与后路伤椎置钉治疗胸腰椎单节段爆裂性骨折的治疗效果。方法选取2008年3月～2011年4月来本院就诊治疗的40例胸腰椎单节段爆裂性骨折患者,随机分为A组和B组。A组20例,采用后路伤椎置钉治疗;B组20例,采用跨节段椎弓根内固定治疗。对比分析两组患者的Frankel分级,后凸角,术中出血量及术后并发症情况。结果对患者随访1～2年,对比分析A组和B组患者术后的后凸角,术中出血量等数据,B组较A组出血量少,但A组后凸角治疗优于B组,术后并发症发生率也较低,P<0.05,差异具有统计学意义。结论后路伤椎置钉是较跨节段椎弓根螺钉内固定治疗胸腰椎单节段爆裂性骨折更为有效,更为安全的一种治疗方式。

Objective To contrast and analysis therapeutic effect of segments of the vertebral screw fixation and posterior root vertebral pedicle screw in treatment of thoracolumbar burst fractures single segment. Methods From March 2008 to April 2011, 40 patients were chosen with thoracolumbar burst fractures single segment who were treated in our hospital, randomly divided them into A group and B group. 20 patients in A group were treated with cross-segment pedicle fixation, B group were treated with posterior vertebral pedicle screw treatment. We compared data of two groups of patients with Frankel grade, kyphosis angle, blood loss and postoperative complications. Results Patients were followed for 1-2 years, compared kyphosis angle, blood loss of group group A and group B patients, group A was better than group B in kyphosis angle treatment and postoperative complication rate was lower, but blood loss of group B was less than group A （P 〈 0.05）, the difference was statistically significant. Conclusion Posterior vertebral pedicle screw is a more effective and securer way than cross-segment pedicle screw fixation in treatment of thoracolumbar burst fractures single segment.