不同手术入路钉棒系统撑开复位内固定治疗胸腰椎骨折的临床观察

Clinical Observation of Nail-stick Fixation with Different Surgical Approach in the Treatment of Thoracic and Lumbar Fracture

目的探讨前入路与后入路钉棒系统撑开复位内固定治疗胸腰椎骨折的临床疗效。方法选择符合标准的患者60例,随机分为观察组和对照组各30例,观察组采用后入路,对照组采用前入路,观察手术效果。结果观察组患者手术时间、术中出血量及术后引流量与对照组比较,差异均有统计学意义(P<0.05)。两组患者术前骨折椎体前后缘高度、Cobb's角及损伤椎体椎管截面积差异均无统计学意义(P>0.05);术后椎体前后缘高度、Cobb's角及损伤椎体椎管截面积较术前明显改善(P<0.05),但是观察组与对照组比较改善更明显(P<0.05)。结论后入路钉棒系统撑开复位内固定治疗胸腰椎骨折安全有效、操作简单,值得临床推广及应用,尤其适合基层医院。

Objective To discuss the clinical efficacy of nail-stick fixation with different surgical approach in the treatment of thoracic and lumbar fracture. Methods 60 patients were divided randomly into observation group （30 cases） and control group （30 cases） . The control group was treated with posterior operation, the observation group was treated with anterior operation, then operation efficacy were compared. Results The operation time, intraoperative blooding and postoperative flow in the observation group were better than that of control group（P〈 0.05）. In postoperative the heights of anterior and posterior vertebral body, Cobb＇s angle and injury of vertebral canal area were obviously improved in all patients（P〈0.05）, while the observation group was better than that of control group, and the difference was statistically significant （P〈0.05）. Conclusion Nail-stick fixation with posterior operation in the treatment of thoracic and lumbar fracture is worthy of clinical application in primary hospital, because it possesses the advantages of high clinical effects, operation simple and safty.