椎弓根螺钉联合连接棒内固定治疗胸腰段脊柱骨折的临床研究

Clinical study of pedicle screw combined with connecting rod internal fixation on thoracolumbar spine fractures

目的探讨椎弓根螺钉联合连接棒内固定治疗胸腰段脊柱骨折临床应用效果。方法 133例胸腰段脊柱骨折患者均接受外科椎弓根螺钉联合连接棒内固定手术治疗,记录患者手术疗效、随访结果、手术相关不良反应发生情况。结果术后Cobb角(4.76°±0.64°)、椎体前缘高度(93.22±2.14)%、椎体后缘高度(96.35±1.23)%,优于术前的(25.49°±0.91°)、(32.36±3.59)%、(72.67±5.24)%(P<0.05);随访成功率为100.00%,且随访2年后患者的Cobb角较术后略有上升,而椎体高度(前缘、后缘)则较之前略有下降(P>0.05);手术相关不良反应发生率仅为6.02%(8例)。结论经椎弓根螺钉联合连接棒内固定手术治疗胸腰段脊柱骨折可获得较为理想的近、远期疗效,安全性较高,有利于预后及改善患者生活质量。

Objective To investigate the clinical effect of pedicle screw combined with connecting rod internal fixation in the treatment of thoracolumbar spine fractures. Methods One hundred thirty-three cases of patients with thoracolumbar spinal fracture underwent surgical pedicle screw and connecting rod internal fixation, the treatment effect, follow-up result and adverse reactions situation were recorded. Results The postoperative Cobb angle was （4.76°±0.64°）, anterior vertebral height was （93.22±2.14）%, posterior vertebral height was （96.35±1.23）%, which were better than（25.49°±0.91°）, （32.36± 3.59）%, （72.67±5.24）% before operation （P〈0.05）; the follow-up success rate was 100%, and after 2 years of follow-up, Cobb angle was higher than that after operative, while the heights of vertebral body （anterior, posterior） were slightly lower than those after operative （P〉0.05）. The incidence of adverse reaction was 6.02% （8 cases）. Conclusion Pedicle screw combined with connecting rod internal fixation in the treatment of patients with thoracolumbar spine fractures can obtain an ideal near and long-term curative effect, with high safety, which is good for the prognosis and improve the patients＇ quality of life.