胸腰椎骨折伤椎置钉与否的疗效比较

Clinical Effect of Pedicle Screw versus Non-pedicle Screw Treatment of Thoracolumbar Fractures in Injured Vertebra

目的：比较经伤椎与跨伤椎椎弓根螺钉复位固定治疗胸腰椎骨折的临床效果。方法回顾性研究胸腰椎椎体骨折患者84例，其中41例采用经伤椎加用椎弓根螺钉固定（A组），43例采用短节段跨伤椎固定（B组）作为对照。观测患者后凸畸形（Cobb角）及伤椎高度恢复情况。结果术后随访15．7月（12～36月），A组在伤椎体高度术后矫正率、远期丢失率、Cobb角变化值及丢失值、内固定失败率方面明显优于B组，2组差别具有统计学意义（P＜0．05）。结论胸腰椎骨折应用伤椎椎弓根螺钉固定有利于矫正后凸畸形和恢复伤椎前缘高度，并且可以增强内固定系统的牢固性和维持矫正效果。

Objective To compare the clinical curative effect of pedicle screw reduction and fixa-tion in or across the injured vertebra for the treatment of thoracolumbar fractures . Methods A retro-spective study was performed on 84 patients with thoracolumbar fractures admitted between October 2008 and October 2011 . Of them ,41 patients were treated with pedicle screw fixation （Group A）and 43 with short segment fixation across the injured vertebra （Group B） . Measurements were made for the kyphosis （Cobb angle）and the height restoration of the injured vertebra . Results The mean follow-up period was 15 .7 months（range ,12~36 months） . Group A made statistically significant and better improvements in post-op height correction of the injured vertebra ,long-term height loss ,Cobb angle change and loss ,and failure of pedicle screw fixation than Group B （P〈0 .05） . Conclusion Pedicle screw fixation for thoraco-lumbar fractures in the injured vertebra can help correct the kyphosis and restore the height of the injured vertebra . It can also help enhance the firmness of the internal fixation and maintain the reduction .