3种不同内固定器治疗胸腰椎骨折的疗效

Comparison of Three Different Internal Fixation Systems for Thoracolumbar Fractures

目的探讨3种不同的内固定方法治疗胸腰椎骨折患者的临床效果。方法对95例胸腰椎骨折的患者按随机数字表法分为3组,分别采用3种不同的内固定系统[通用型脊柱内固定系统(GSS)(GSS组,32例)、脊柱复位内固定器AF钉棒系统(AF组,32例)和脊柱复位内固定器RF钉棒系统(RF组,31例)]进行治疗,对3组患者的复位效果、手术时间、术中出血量,以及神经恢复和并发症等进行比较。结果 GSS组的手术时间短于AF组和RF组,术中出血量也显著少于AF组和RF组(均P<0.05)。3组患者经手术复位后的Cobb角、矢状面位移和伤椎高度较术前明显改善,而GSS组的改善情况较之AF组和RF组更为显著(P<0.05)。3组患者术后均随访1年以上,神经功能Frankel分级较术前均明显好转,但3组间比较差异均无统计学意义(均P>0.05)。结论 GSS系统具有操作简便、复位力大、复位效果好、固定牢度高的优点,是治疗胸腰椎骨折的一种较好的内固定方法。

Objective To compare the curative effects of three different internal fixation systems on thoracolumbar fractures. Methods Ninety-five patients with thoracolumbar fractures were randomly divided into three groups and treated with general spinal system （GSS group, 32 cases）, atlas fixator（AF group, 32 cases）or reduction fixator （RF group, 31 cases）, respectively. Reduction efficacy, operative time, intranperative blood loss, neurological recovery and complications were compared among the three groups. Results Compared with GSS group, the operation time and intranperative blood loss significantly increased in AF group and RF group （P〈O.05）. The Cobb angle, sagittal displacement and height of injured vertebrae were significantly improved by surgical reduction and the improvement in GSS group was more obvious than that in AF group or RF group （P〈0.05）. After follow-up for more than 1 year, Frankel grade was significantly improved but no obvious differences were found among the three groups （P〉0.05）. Conclusion The GSS is simple to operate and leads to good reduction of fractures and firm fixation in thoracolumbar fractures. Therefore, it is a good internal fixation method for treatment of thoracolum-ber fractue.