后路手术治疗脊柱胸腰段骨折临床疗效观察

目的探讨后路手术治疗脊柱胸腰段骨折的临床疗效。方法 55例胸腰段骨折患者分为两组,观察组31例经后路行椎弓根螺钉内固定结合伤椎内植骨手术,对照组24例联合应用外侧植骨融合术,比较两组手术前后伤椎前、后缘高度比值,Cobb角及VAS评分改善情况。结果两组术后椎体高度恢复理想,后凸成角畸形矫正明显。平均随访16个月后,观察组伤锥椎体前缘高度比值、VAS评分改善情况均显著优于对照组([92.2±1.7)%比85.0±2.1)%,(6.7±1.5)分比(5.6±1.2)分,P<0.05],Cobb角矫正情况比较差异有统计学意义([7.8±1.0)°比(12.0±0.9)°,P<0.01]。结论后路椎弓根螺钉内固定结合经椎弓根伤椎内植骨能有效恢复伤椎高度,减少后凸矫正角度丢失,临床效果满意。

Objective To evaluate the clinical curative effect of thoracolumbar fracture surgery with the posterior approach. Methods Fifty-five cases of thoracolumbar fractures were divided into two groups,31 patients received posterior pedicle screw fixation combined with bone graft surgery,24 patients received posterolateral fusion. The clinical results of the correetion of height of injured vertebrae,the Cobb angulation and VAS score were evaluated.Results Compared with the preoperative vertebral body height,kyphosis correction of angular deformitites,surgical results were satisfactory. Follow up after 16 months,compared the control group,the difference of the correetion of height of injured vertebrae, the Cobb angulation and the the VAS score between the two groups were was significant.Conclusion Posterior fixation with pedicle screw system plus transpedicular grafting can make fracture with satisfactory restoration and Prevent the loss of correction.