胸腰段脊柱骨折患者采用跨伤椎固定与经伤椎固定治疗的效果对比

Comparison of the Effect of Cross-wound Vertebral Fixation and Via-wound Vertebral Fixation in Patients with Thoracolumbar Spine Fracture

目的对比胸腰段脊柱骨折患者采用跨伤椎固定与经伤椎固定治疗的效果。方法方便选择2016年1—12月期间该院收治的胸腰段脊柱患者88例,以随机数字表为分组原则将其分为对照组(44例)与研究组(44例)。对照组采取跨伤椎固定治疗,研究组采取经伤椎固定治疗。观察对比两术前与术后即刻功能性障碍与疼痛症状的变化,以及两组术前与术后Cobb角、术后即刻矫正度与6个月时矫正的丢失度。结果研究组术后JOA评分(23.3±1.5)分,高于术前(18.4±1.6)分(P<0.05);VAS评分(2.4±0.8)分,低于术前(7.2±1.2)分(P<0.05)。对照组术后JOA评分(23.6±1.4)分,高于术前(18.5±1.4)分(P<0.05);VAS评分(2.6±1.3)分,低于术前(7.3±1.6)分(P<0.05)。两组术后JOA与VAS评分对比差异无统计学意义(P>0.05)。研究组术后Cobb角(2.0±1.3)°与6个月时矫正的丢失度(1.2±0.5)°低于对照组(4.6±1.6)、(1.9±0.8)°(P<0.05),术后即刻矫正度(13.2±5.8)°高于对照组(8.5±4.2)°(P<0.05)。结论胸腰段脊柱骨折患者采用经伤椎固定的远期效果优于跨伤椎固定,适于临床应用。

Objective This p ap e r tr ies to comp are th e effect of th o racolum b ar spin e frac tu res in p a t ien ts with c ro s s - in ju ry and via-injury vertebral fixation. Methods 88 p a t ien ts with th o racolum b ar spin e adm it ted in this h o sp i ta l from Jan u a ry to December 2016 were convenient select ion randomly divided into the control group （44 cases） and the study group （44 cases） by random number table. The control group was treated with cross-injury ver tebral fixation, and the s tudy group was treated with via-injury ver tebral fixation. The changes of functional dys function and pain symptoms before and af ter surgery, as well as the two groups of preoperative and pos toperative Cobb angle, immediate correction and 6 months af ter the loss degree of correction were observed and compared. Results In th e s tudy group, th e p ostoperative JOA score was （2 3 .3±1 .5 ）p oints, h ig h -er than that before the operat ion of （18.4±1.6）points （P〈0.05）. The VAS score was （2.4±0.8）points , lower than that before the operat ion of （7.2±1.2）points （P〈0.05） . In the control group, the postoperative JOA score was （23.6±1.4）points, higher than that before the preoperative of（18.5±1.4）points （P〈0.05）; the VAS score was （2.6±1.3）points , lower than that before the pre-operat ive of （7.3±1.6） points （P〈0.05）. There was no signif icant difference in JOA and VAS scores between the two groups （P〉0.05）. In the s tudy group, the Cobb angle was （2.0±1.3）° an d th e co r re c ted loss was （1 .2± 0.5）0 at 6 months, lower th an that in the control group of （4.6±1.6）, （1.9±0.8）°（ P 〈 0.05 ）. The posto pe ra tiv e co rrec tio n deg ree was （1 3 .2±5 .8 ）. ,h ig he r than that of the control group of （8.5±4.2）°（ P 〈 0 .0 5 ） . Conclusion The lo n g - te rm effect of v ia-in ju ry v e r teb ra l fixation for th o ra -columbar spine fractures is better than that of cross-injury ver tebral fixation, which is suitable for cl inical application.