经伤椎连续固定治疗胸腰椎爆裂骨折120例临床疗效观察

Clinical Observation of Consecutive Pedicle Screw Fixation for 120 Thoracolumbar Burst Fracture Patients

目的探讨经伤椎连续固定治疗胸腰椎爆裂骨折的临床疗效及安全性。方法将本院2006年7月至2010年7月收治的120例胸腰椎爆裂骨折患者随机分为实验组和对照组,实验组患者进行经伤椎连续固定治疗,对照组患者给予跨节段椎弓根螺钉固定术,比较两组患者术前、术后1周、术后6个月的椎体压缩率、Cobbs角、VAS评分,并统计两组患者术后12个月后凸畸形、腰背疼痛、内固定断裂等术后并发症的发生率。结果两组患者术前、术后1周椎体压缩率、Cobbs角、VAS评分无统计学差异(P>0.05),而术后6个月实验组的椎体压缩率、Cobbs角、VAS评分显著优于对照组(P<0.05),实验组术后并发症的发生率也显著低于对照组(P<0.05)。结论经伤椎连续固定能够降低胸腰椎爆裂骨折手术术后并发症的发生率,临床疗效显著,值得推广应用。

Objective To explore the clinical efficacy and safety of consecutive pedicle screw fixation for thoracolumbar burst fractures. Methods 120 patients with thoracolumbar burst fractures in our hospital from July 2006 to July 2010 were randomly divided into experimental group and control group. The experimental group were treated with consecutive pedicle screw fixation, and the control group were treated with short-segment pedicles crew fixation, to compare vertebral compression ratio, Cobbs angle, VAS score between the two groups before the operation, one week later and 6 months later as well as the incidence of postoperative complications after 12 months. Results Vertebral compression ratio, Cobbs angle and VAS score had no significant difference between the two groups before operation, one week later （P 〉0.05）, but after 6 months, vertebral compression ratio, Cobbs angle VAS score of the experimental group were significantly lower than the control group （P 〈0.05）. Incidence of postoperative complications of the experimental group was also significantly lower than the control group （P 〈0.05）. Conclusions Consecutive pedicle screw fixation can reduce the incidence of postoperative complications with significant clinical efficacy, which is worthy of wide application.