跨伤椎固定与经伤椎固定治疗胸腰段脊柱骨折的疗效对比

Comparison of clinical curative effect of pedicle screw fixation via the injured vertebra and across injured vertebra for thoracolumbar spine fracture

目的对比分析跨伤椎固定与经伤椎固定治疗胸腰段脊柱骨折的临床疗效。方法回顾性分析自2009年5月～2012年4月收治的81例胸腰段脊柱骨折的临床资料，将43例接受经伤椎固定的患者作为实验组，38例接受跨伤椎固定的患者作为对照组。对比分析两组手术前后影像学指标的变化与临床疗效。结果实验组与对照组术前与术后即刻VAS、JOA评分比较，差异均无统计学意义（P〉0．05）；两组术前Cobb角度比较差异无统计学意义（P〉0．05），术后实验组即刻Cobb角度、即刻矫正度、术后半年Cobb角度及术后半年矫正丢失度均显著优于对照组（P〈0．05）；实验组伤椎前后缘术后即刻矫正度、术后半年相对高度及半年矫正丢失度要显著优于对照组（P〈O．05）。结论经伤椎固定治疗胸腰段脊柱骨折的l临床疗效要优于跨伤椎固定，其复位效果更佳，术后能够较好地维持脊柱矫正度，值得临床推广应用。

Objective To compare the clinical curative effect of pedicle screw f＇Lxation via the injured vertebra and across the injured vertebra for thoracolumbar spine fracture. Methods The clinical data of 81 patients with thoracolumbar spine fracture who came to our hospital from May 2009 to April 2012 was retrospectively analyzed. Forty three patients who accepted pedicle screw fLxation via the injured vertebra were divided into the experimental group while 38 patients who accepted pedicle screw fLXation across the injured vertebra were divided into the control group. The changes of imaging indicators and clinical curative effect of two groups were compared and analyzed. Results The difference of preoperative and immediate postoperative JOA and VAS score of between the two groups was not statistically different （P 〉0.05）; the difference of Cobb＇s angles before the surgery between the two groups was not statistically different （P 〉0.05）, the average immediate postoperative Cobb＇s angles, correction of Cobb＇s angle, mean kyphosis correction loss and Cobb＇s angle after 6 months of the experimental group was statistically better than that of the control group （P 〈0.05）; immediate postoperative correction of fractured vertebra, relative height and kyphosis correction loss after 6 months of the experimental group was statistically better than that of the control group（P 〈0.05）. Conclusion The clinical curative effect of pedicle screw fixation via the injured vertebra is better than that of across the injured vertebra fLxation for thoracolumbar spine fracture, which has a better reset and is better in maintaining the correction of the spine. It is worth promoting.