胸腰椎爆裂性骨折早期前后路手术治疗临床疗效观察

Clinical analysis of primary phase through anterior or posterior approach operation for thoracolumbar burst fracture

【目的】比较早期前后路手术在治疗胸腰椎爆裂性骨折中的临床疗效。【方法】对采用前路或后路手术治疗的76例胸腰椎骨折患者,从复位效果、术中出血量、手术时间、神经恢复情况及并发症发生率等方面进行观察,分析比较两种手术方法的临床疗效差异。【结果】两组病例病椎高度均得到较好恢复,脊柱畸形得到有效矫正,脊柱稳定性得到较好重建,脊髓功能恢复良好;后路手术平均手术时间短,平均出血量少,并发症少。【结论】前后路手术在恢复椎体高度、矫正Cobb氏角、脊髓功能的恢复方面无显著性差异,后路手术具有创伤小、操作较简单、出血量少、手术时间短等优点,多数早期骨折病例经过后路手术均可达到满意疗效。

【Objective】This study is aimed to compare the clinical effects between the anterior and posterior surgical approach for thoracolumbar burst fracture in primary stage.【Methods】 There are 76 patients with thoracolumbar burst fracture undergone anterior or posterior approach operation.The clinical effects were evaluated by the factors such as reduction effects,blood loss,operation time,nerve recovery and complication.【Results】 The patients with vertebral disease in the two groups were recovered.Spinal deformity was effectively corrected and spinal stability was reconstructed with good spinal cord function.By comparison,the average operation time in posterior group was shorter than that in anterior group.Meanwhile the posterior group had less blood loss and lower complications rate.【Conclusion】 Anterior and posterior surgical approach shows no significant difference in the recovery of vertebral body height,Cobb’s Angle correction and spinal cord function recovery;however posterior surgical appraoch has advantages in small wound,simple operation,less bleeding loss and shorter operation time,which is worth being promoted in clincal.