短节段与经伤椎短节段椎弓根螺钉治疗胸腰段骨折的临床研究

Comparison of clinical effect of short segment and posterior short-segment pedicle screw in the treatment of thoracolumbar spine fractures

目的比较短节段与经伤椎短节段椎弓根螺钉治疗胸腰段骨折的临床疗效。方法按照随机数字表法将86例胸腰段脊柱骨折患者分为试验组和对照组,每组43例。试验组给予经伤椎短节段椎弓根螺钉内固定治疗,对照组给予短节段椎弓根螺钉内固定治疗。两组均随访6个月,比较两组椎管狭窄率、Cobb角和椎体前缘高度比的变化情况以及神经功能改善效果。结果两组患者治疗后椎管狭窄率均显著下降,与治疗前比较,差异有统计学意义(P<0.05);试验组治疗后椎管狭窄率显著低于对照组,差异有统计学意义(P<0.05);两组治疗后Cobb角均显著下降,椎体前缘高度比均显著升高,与治疗前比较,差异具有统计学意义(P<0.05);试验组治疗后Cobb角显著低于对照组,椎体前缘高度比显著高于对照组,差异具有统计学意义(P<0.05);试验组神经功能改善的总有效率显著高于对照组,差异具有统计学意义(P<0.05)。结论采用经伤椎短节段椎弓根螺钉治疗胸腰段骨折脊柱稳定性好、术后椎管狭窄率低、Cobb角和椎体前缘高度恢复情况好、神经功能改善效果显著,临床应用价值较高。

Objective To compare the clinical effect of short-segment and posterior short-segment pedicle screw in the treatment of thoracolumbar spine fractures. Methods According to random number table, 86 patients with thoracolumbar fracture were divided into experimental group and control group, 43 cases in each group. The experimental group were treated by posterior short-segment pedicle screw; The control group were treated by short-segment pedicle screw fixation. Results After treatment, the spinal stenosis rate of the two groups were significantly decreased. Compared with before treatment, the difference was statistically significant （ P 〈 0.05 ）. After treatment, the stenosis rate of the experiment group were significantly lower than that of control group （P 〈 0.05）. Compared with before treatment, the Cobb angle of the two groups were significantly decreased and the height of the vertebral body height was significantly higher （P 〈 0.05 ）. After treatment, the cobb angle of experimental groups were significantly lower than that of control group, the height of vertebral body was significantly higher than that of the control group （P 〈 0.05 ）. The improve of neurological function of the experiment group were better than the control group （P 〈 0.05 ）. Conclusion Posterior short-segment pedicle screw show high clinical effect in the treatment of thoracolumbar spine fractures.