期刊文献+

前后路减压治疗胸腰段脊柱骨折合并脊髓损伤的对比分析 被引量:31

Clinical analysis of anterior and posterior decompressions for treating thoracolumbar spine fractures combined with spinal cord injury
下载PDF
导出
摘要 目的比较分析前后路减压治疗胸腰段骨折合并脊髓损伤患者的手术方法及其疗效。方法回顾性分析2013年5月~2015年2月住院治疗的60例胸腰段骨折合并脊髓损伤患者的临床资料,根据手术方法分为前路组和后路组(各30例),前路组采用前路减压法治疗,后路组采用后路减压法治疗,比较两组患者治疗时间、出血量以及触觉评分、运动评分、伤椎高度、Cobb’s角。结果前路组平均术中出血量(598.3±46.1)m L,后路组(358.2±34.1)m L,前路组多于后路组(P〈0.05);后路组平均手术时间(201.6±21.5)min,前路组(243.8±16.8)min,前路组多于后路组(P〈0.05)。两组治疗前触觉评分及运动评分均无差异(P〉0.05)。后路组治疗后平均触觉评分为(56.4±12.2)分、运动评分为(54.4±14.8)分,前路组则分别为(76.0±14.5)分、(76.5±18.3)分,两组均较治疗前显著改善,且前路组优于后路组(P〈0.05)。前路组治疗后平均Cobb’s角(44±5)°、伤椎高度(3.8±0.5)cm,后路组(31±2)°、(2.5±0.4)cm,两组均较治疗前显著改善,且前路组相比后路组治疗后更优(P〈0.05)。结论前后路减压疗法各有优势,前路减压法复位效果更好,可显著解除脊髓受压情况,改善触觉、运动功能以及伤椎高度、Cobb’s角,在临床上有很大应用前景。 Objective To compare and analyze the surgical methods and clinical effects of anterior and posterior decompressions for treating thoracolumbar fractures with spinal cord injury. Methods The clinical data of60 patients with thoracolumbar fractures combined with spinal cord injury in our hospital from May 2013 to Feb.2015 was retrospectively analyzed. According to the surgical method,the 60 cases were divided into anterior and posterior groups,with 30 cases in each group. The anterior group was treated with anterior decompression,and the posterior group was treated with posterior decompression. The operation time,bleeding volume,tactile score,motor score,vertebral height,and Cobb's angle were compared between the two groups. Results The mean blood loss in the anterior group was( 598. 3 ± 46. 1) m L,and was( 358. 2 ± 34. 1) m L in the posterior group,which was more in the anterior group than that in the posterior group( P〈0. 05). The average operation time was( 201. 6 ± 21. 5) min in the posterior group,and was( 243. 8 ± 16. 8) min in the anterior group,which was longer in the anterior group than in the posterior group( P〈0. 05). There was no difference between the two groups before treatment in tactile and motor score( P〈0. 05). After treatment,the average tactile score was( 56. 4 ± 12. 2) points and the motor score was( 54. 4 ± 14. 8) points in the posterior group,and was( 76. 0 ± 14. 5),( 76. 5 ± 18. 3) points,respectively in the anterior group. The two groups were significantly improved after treatment,and the anterior group improved more significantly than the posterior group( P〈0. 05). After treatment,the mean anterior Cobb's angle was( 44 ±5) °,the vertebral height was( 3. 8 ± 0. 5) cm in the anterior group,and was( 31 ± 2) °,( 2. 5 ± 0. 4) cm,respectively in the posterior group. The two groups were significantly improved after treatment,and the anterior group improved more significantly( P〈0. 05). Conclusion Anterior decompression in the treatment of thoracolumbar fracture with spinal cord injury patients can significantly relieve spinal cord compression and improve tactile and motor function as well as vertebral height and Cobb's angle. It is worthy promoting in clinical practice.
出处 《创伤外科杂志》 2016年第7期422-425,共4页 Journal of Traumatic Surgery
关键词 脊椎骨折 脊髓损伤 胸腰段 减压 入路 spinal fracture spinal cord injury thoracolumbar decompression approach
  • 相关文献

参考文献8

二级参考文献99

  • 1刘尚礼,吕浩然(协助整理).重视胸腰段骨折治疗[J].中华创伤杂志,2006,22(1):5-7. 被引量:57
  • 2张超,阮狄克,何勍,李景云,王鹏建.脊柱骨折再手术原因及疗效[J].中国矫形外科杂志,2007,15(4):241-243. 被引量:10
  • 3Dai LY.A review of themanagement of thoracolumbar burst fractures[J].Surg Neurol,2007,67 (3):221.
  • 4Shaffrey CI.Surgicaltreatment of thoracolumbar fractures[J].Neurosurg Clin N Am,1997,8(4):519.
  • 5Chipman JG.Earlysurgery for thoracolum bar spine injuries decreaseseomplications[J].J Trauma,2004,56(1):52.
  • 6Dai LY.Thoracolumbar frae.tures in patients with multiple injuries:diagnosis andtreatment:A review of 147 cases[J].J Trauma,2004,56(2):348.
  • 7Stambough.Posterior instrumentation for thora,columbar trauma[J].Clin Orthop,1997(335):73.
  • 8Singh K,Heller JG,SamartzisD,et al.Open vertebral cement augmentation combined with lumbar decompression for the operative management of thoracolumbar stenosis secondary to ostceporotic burst fractures.J Spinal Disord Tech,2005,18(5):413-419.
  • 9Denis F.Spinal stability as defined by the three olunm spine concept in acute spinal trauma.Clin Orthop Relat Res,1984,(189):65-76.
  • 10Max A,John ST,John KW,等,党耕町,刘忠年.陈仲强,主译AOASIF脊柱内固定第1版.北京:人民卫生出版社,2000.80-100.

共引文献112

同被引文献213

引证文献31

二级引证文献225

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部