胸腰段骨折后椎体高度恢复的影响因素探讨

Influencing Factors of Vertebral Height Recovery After Thoracolumbar Fracture

目的探讨脊柱骨折后致椎体后凸畸形及椎体高度丢失的影响因素及防治措施。方法回顾性分析医院近10年收治的200例不同类型椎体存在不同程度塌陷的脊柱骨折患者的治疗方法。分为传统保守治疗组(非手术组)46例和手术治疗组154例,其中手术治疗组又分为椎弓根钉内固定术组(45例)、椎弓根钉内固定+经椎弓根植骨术组(56例)、经皮椎体成形术组(53例)。比较4种治疗方式对椎体骨折后椎体高度恢复的影响。结果相比非手术治疗,手术治疗的伤椎高度得到了有效恢复(P<0.05)。结论椎体骨折的不同治疗方法各有优缺点,经椎弓根植骨术及椎体成形术对于恢复、维持椎体高度,减少功能损害更有效且有益。

Objective To investigate the influencing factors of vertebral kyphosis and loss of vertebral height after thoracolumbar fracture,and tits prevention and treatment measures. Methods A retrospective analysis was performed on 200 spinal fractures patients with different degrees of collapse in different types of vertebral bodies admitted to our hospital in ten years. The patients were divided into traditional conservative group（ non-operation group,46 cases） and the operation group（ 154 cases）,and the operation group was divided into internal transpedicular fixation group（ 45 cases）,internal transpedicular fixation ＋ vertebral pedicle bone graft group（ 56 cases）and percutaneous vertebroplasty group（ 53 cases）. The effects of 4 methods on the recovery of vertebral height after vertebral fracture were compared. Results Compared with non-operation group,the vertebral height of the operation group was effectively restored（ P〈0. 05）. Conclusion Different treatment methods for vertebral fractures have their respective advantages and disadvantages,the methods of vertebral pedicle bone graft and percutaneous vertebroplasty are more effective and beneficial for recovery,maintenance of vertebral height,and reduction of functional impairment.