胸腰段脊柱骨折不同节段固定对手术疗效的影响

Comparison of clinical effect of pedicle fixation in different segments in thoracolumbar spine fractures

目的比较后路椎弓根钉不同节段固定对重度胸腰段脊柱骨折疗效的影响。方法对78例重度胸腰段脊柱骨折采用短节段固定50例,经伤椎短节段固定10例,长节段固定18例,随访时评价椎体前后缘高度及后凸Cobb角变化,并统计3组的手术时间、出血量、Oswestry评分。结果多节段固定在预防脱位防止椎体前缘高度丢失及后凸角度丢失方面有明显的优势,经伤椎短节段固定在伤椎复位方面有很好的疗效。结论后路长节段固定在重度胸腰段脊柱骨折治疗中能达到良好的复位和减压目的。经伤椎短节段固定尤其在合并严重脱位方面更具优势。

Objective To compare the clinical effect of long versus short segment pedicle screw system for treatment in serious thoracolumbar spine fracture. Methods Sixty of 78 cases were fLxed with short segment and others were fLxed with long segment. The height of anterior and posterior edge of vertebral body and posterior convex angle were evaluated. And the operative time, blood loss and Oswestry function scores were analyzed. Results Long segment fixation was superior to prevent dislocation, loss of anterior edge height of vertebral body and posterior convex angle than that in short segment fLxation. Short segment fixation with compressed vertebra might be a helpful choice. Conclusion Satisfactory vertebral reduction and decompression could be gained in serious thoracolumbar spine fracture by long segment. Short segment fLxation with compressed vertebra may be a helpful choice.