不同入路植入物内固定治疗腰椎爆裂性骨折

Comparison of the curative effect of different approached of implantation implant internal fixation on lumbar burst fractures

目的：比较不同入路植入物内固定治疗腰椎爆裂性骨折的疗效。方法选择2011年4月至2013年12月97例腰椎爆裂性骨折患者为研究对象，并将其分为两组。 A组由脊柱后路入路，B组采取前后联合入路，比较两组手术时间、术中出血量、术后Cobb角丢失与疼痛情况及并发症发生率。结果 A组手术时间、术中出血量均低于B组，疼痛评分高于对照组，疼痛程度更轻，但 Cobb 角丢失值高于B 组，差异比较均有统计学意义（P＜0．05）。A组并发症发生率为12．2％，高于B组，比较差异有统计学意义（P＜0．05）。结论后路入路与前后路联合入路治疗腰椎爆裂性骨折各有优缺点，需结合患者实际情况确定合适入路方式。

Objective To compare the different approaches of placement of implant internal fix-ation in treatment of lumbar burst fractures .Methods Selected 97 cases of lumbar burst fractures from April 2011 to December 2013 , and divided them into two groups .Group A was in posterior spinal ap-proach, and group B adopted combined anterior and posterior approach .Compared operation time , bleeding volume , postoperative Cobb angle loss and pain and the incidence of complications of two groups .Results The operation time , intraoperative blood volume in group A were lower than those in group B , and the pain score was higher than that in group B , pain degree was lighter , but the Cobb angle loss value was higher than that of group B , all of the differences were significant （P〈0.05）.The com-plication rate in group A （12.2%） was higher than that in group B , the difference was significant （ P〈0.05） .Conclusions Posterior approach and combined anterior and posterior approach in treatment of lumbar burst fractures have advantages and disadvantages , appropriate approach need to be combined with the actual situation of patients .