胸腰椎骨折行伤椎与跨伤椎椎弓根内固定术临床疗效比较

The analysis of clinical evaluation of the operating method using the fixation treatment of vertebral pedicle and cross it injuried at the thoraco lumbar fracture

目的探讨椎弓根内固定术两种术式治疗胸腰椎骨折的临床疗效。方法回顾性分析我科自2007年3月至2011年7月收治的134例胸腰椎骨折患者的临床资料,行跨伤椎椎弓根内固定术患者67例(A组),行伤椎椎弓根内固定术患者67例(B组),随访12～15个月(平均13个月)。结果两组患者术前伤椎前缘高度、矢状指数、Cobb角比较差异无统计学意义(P>0.05),术后24周、48周两组间患者矢状指数、Cobb角比较差异有统计学意义(P<0.05),48周随访时行腰痛治疗结果评分(low back outcome score,LBOS)两组间差异无统计学意义(P>0.05)。结论伤椎椎弓根内固定术治疗胸腰椎骨折行之有效,对伤椎畸形的矫正和内固定效果优于跨伤椎椎弓根内固定术,值得临床探讨应用。

Objective To explore the clinical effect of two kinds of surgical treatment using the fixation of vertebral pedicle and cross it as regards the thoraco lumbar fractures.Methods Clinical data of 134 cases of one level thoraco lumbar fracture in our department from March 2007 to July 2011 were retrospectively analyzed.Two groups were devided.One group was across the vertebral pedicle fixation injury patients in 67 patients（group A）and another was through injury vertebral pedicle fixation in 67 patients（group B）.All the cases were followed up for 12 ~ 15 months（13 months on average）.Results Two groups were comparative analyzed in terms of fractured vertebral height,injury vertebtal sagittal index and Cobb Angle.It was not statistically significant difference between them in preoperative（P0.05）.Each index compared was statistically significant difference between the two groups in postoperative 24 weeks and 48 weeks（P0.05）.Waist pain score（low back outcome score,LBOS） was statistically significant difference between the two groups in postoperative 48 weeks（P0.05）.Conclusion It is effective through the fractured vertebral pedicle fixation treatment of thoraco lumbar fractures.To hurt the modification for the fractured vertebral malformation and the effect of surgery,it is better than that of vertebral pedicle across the injury internal fixation.Clinical application is discussed.