胸腰椎骨折伤椎置钉固定的疗效观察

The clinical observation to thoracolumbar fracture with injuried vertebra transpedicular fixation

目的：比较经伤椎置钉与跨伤椎置钉内固定技术治疗胸腰椎骨折的临床效果。方法对82例胸腰椎骨折患者分别采用伤椎置钉内固定（ A组,42例）和跨节段椎弓根螺钉内固定（ B组,40例）治疗。观察两组椎体高度矫正率、Cobb角矫正率及Oswestry功能障碍指数、内固定失败率等项临床指标。结果患者均获随访,时间6个月-2年。 A组在椎体高度矫正率、Cobb角矫正率、Oswestry功能障碍指数、内固定失败率方面均优于B组,差异具有统计学意义（P〈0．05）。结论两种置钉内固定技术对治疗胸腰椎骨折均有效,经伤椎置钉内固定术的疗效更好、更持久。

Objective To investigate the clinical effect of transpedicular fixation with or without injured vertebra in the treatment of thoracolumbar fracture. Methods 82 patients with thoracolumbar fracture were included in this study. They were divided into group A （42 cases）, which were treated by pedicle screw fixation with injured vertebra and group B （40 cases ）, which were treated by pedicle screw fixation without injured vertebra. The correct-rate of vertebral body height, Cobb angle, Oswestry disability index and fixation failure rate were measured and then com-pared the clinical effect. Results All patients were followed up with 6 months to 2 years. The patients in group A were superior in the correct-rate of vertebral body height, Cobb angle, Oswestry disability index and fixation failure rate compared with patients in group B, and there was significant difference （P〈0. 05）. Conclusions Two treat-ments for thoracolumbar fractures are valid, pedicle screw fixation with the injured vertebra transpedicular is better and has more lasting curative effect.