后路椎弓根钉固定结合硫酸钙骨水泥椎体成形术治疗新鲜胸腰椎压缩性骨折疗效分析

Posterior Pedicle Fcrew Fixation Combined with Calcium Sulfate Cement of Vertebral Plasty in the Treatment of Thoracolumbar Compression Fractures

目的研究后路椎弓根钉固定术结合硫酸钙骨水泥椎体成形术治疗胸腰椎压缩性骨折的临床效果。方法整群选取2010年4月—2015年5月收治的68例胸腰椎压缩性骨折患者,随机分为A组和B组。B组患者采用后路椎弓根钉固定术治疗,A组在B组基础上联合硫酸钙骨水泥椎体成形术治疗。于术前、术后3个月记录Cobb角、椎体前缘高度压缩率、椎体后缘高度压缩率,比较组间差异。结果所有患者经治疗后,其胸腰部功能指标较术前均有明显恢复。术前患者Cobb角为20°左右,术后患者降至1-6°;术前椎体前缘高度压缩率为40%左右,术后降至2%-10%之间;术前椎体后缘高度压缩率为10%左右,术后降至1%-5%之间。组间比较,术后A组Cobb角、椎体前缘高度压缩率、椎体后缘高度压缩率明显低于B组,P〈0.05差异有统计学意义。结论后路椎弓根钉固定术结合硫酸钙骨水泥椎体成形术治疗胸腰椎压缩性骨折疗效良好,值得临床推广应用。

Objective To study the clinical effect of posterior pedicle screw fixation combined with calcium sulfate cement of vertebral plasty in the treatment of thoracolumbar vertebral compression fractures. Methods Group selection 68 cases collected from April in 2010 to May in 2015 of thoracolumbar fracture were randomly divided into A group and B group.B patients were treated in posterior pedicle screw fixation.Patients in the A group were treated with calcium sulfate and vertebral bone cement angioplasty on the basis of B group.To evaluate lumbar function with the Cobb angle, anterior vertebral height compression ratio and the posterior margin of the vertebral body before treatment and after 3 months, and the difference was compared between the two groups. Results All the patients chest waist function index recovered after the treatment. Preoperativ Cobb angle of patients is about 20, while dropped to 1 to 6 degrees after operation; preoperative vertebral height of compression rate is about 40%, while postoperative fell to 2%-10%; preoperative vertebral highly compressed rate is about 10%, while postoperative dropped to between 1%-5%. Comparison between groups, the Cobb angle, anterior vertebral height ratio, vertebral height compression rate in A group was significantly lower than that of B group, P〈0.05, with significantly different. Conclusion Posterior pedicle screw fixation combined with calcium sulfate cement vertebral plasty in the treatment of thoracolumbar compression fractures has good effect, it is worthy of clinical application.