胸腰椎骨折手术适应证及其远期疗效观察

Thoracolumbar fractures and long-term efficacy of surgical indications

目的探讨胸腰椎骨折的手术适应症和患者的远期疗效,以供临床参考。方法将我院2002年1月～2009年1月收治的胸腰椎骨折患者随机分为两组,A实验组给予经椎弓根内固定治疗,B实验组给予椎管环形减压手术,比较两组患者中不同神经损伤情况患者的治疗效果,以分析胸腰椎骨折的手术适应症。结果 A实验组患者中,所有患者均得到了疗效,脊髓不完全损伤患者分别提高了1～3级,脊髓完全损伤患者神经根功能明显的恢复。B实验组患者中,脊髓不完全损伤患者中,所有患者均取得了较好的疗效,而脊髓完全损伤患者中,有8例患者神经根功能无恢复。结论对伴有脊髓损伤的患者,其需要给予手术治疗。其中经椎弓根内固定所有脊髓损伤患者均有较好的治疗,对脊髓完全损伤患者,需要慎重采用椎管环形减压手术。

Objective： To investigate the indications for thoracolumbar fractures of the long-term efficacy and patients for clinical reference.Methods： The thoracolumbar fractures treated in the hospital in January 2002-January 2009 were randomly divided into two groups,A test group was given by pedicle fixation,B ring experimental group was given spinal decompression surgery,the two groups of patients with nerve damage in patients were observed with different treatments,and the indications for thoracolumbar fractures were analyzed.Results： In the A test group,the treatment had the good effect on all the patients,the patients with incomplete spinal cord injury were increased by the levels of 1 to 3,and the patients with spinal cord injury had a significant recovery of nerve root function.In the experimental group B,the patients with incomplete spinal cord injurys achieved good effect,and in the patients with spinal cord injury,8 patients didn’t have nerve root functional recovery.Conclusion： For patients with spinal cord injury,surgery is needed.All of patients by the pedicle screw spinal cord injury have a better treatment.The patients with spinal cord injury require careful use of the ring canal decompression surgery.