内固定治疗胸腰椎爆裂骨折临床疗效观察

Observation on the Clinical Curative Effect of Internal Fixation on Thoracolumbar Burst Fracture

目的探讨和分析经伤椎椎弓根固定在治疗胸腰椎与爆裂骨折中的临床治疗效果。方法选取该院在2012年11月—2014年9月期间收治的68例患者作为研究对象,其患者均属于胸腰椎与爆裂骨折,且采用经伤椎椎弓根置钉方案进行治疗,对全部患者的随诊以及回访结果进行记录并作临床分析。结果所有病例均在1年内定期接受随访。手术后1年病椎前缘高度、椎管狭窄程度分别为95%和96%,明显优于手术前,患者手术后1年病椎前缘高度和椎管狭窄程度与手术前对比,差异有统计学意义(P<0.05);术后1年患者的Cobb's角以及腰背疼痛VAS评分为(5.1±0.9)o和(1.1±0.5)分,全部优于手术前,该两项指标在术前、术后进行对比,差异有统计学意义(P<0.05)。结论采用经伤椎椎弓根置钉即在一侧或者双进行固定的方案来治疗胸腰与椎爆裂骨折的手术,不但操作非常安全,而且手术后患者病情进行恢复的效果非常满意。因此,经伤椎椎弓根固定治疗胸腰与椎爆裂骨折手术,非常有临床推广价值。

Objective To investigate and analyze the clinical treatment effect of pedicle screw fixation via the injured vertebrae in the treatment of thoracolumbar burst fracture. Methods Sixty-eight cases with thoracolumbar burst fracture admitted in our hospi-tal from November 2012 to September 2014 were selected as the subjects and treated by the pedicle screw fixation via the injured vertebrae. The result of follow-up and return visit of all the patients were recorded and analyzed clinically. Results All patients re-ceived regular follow-up in 1 year. 1 year after operation, the anterior height of vertebral disease, spinal stenosis degree was 95%, 96%, respectively, significantly better than that before the operation, respectively, the differences were statistically significant （ P〈0.05）; 1 year after surgery, the Cobb＇s angle and pain in back and loin VAS score of the patients was （5.1±0.9） o and （1.1±0.5） points, respectively, better than that before the operation, respectively, the differences in the two indexes before and after surgery were statistically significant（P〈0.05）. Conclusion For thoracolumbar burst fracture, pedicle screw fixation via the injured vertebrae, namely, unilateral fixation or bilateral fixation, is safe to operate, and the postoperative recovery of the patients is very satisfactory, therefore the surgery is of great clinical value of promotion.