前路减压植骨内固定治疗胸腰段脊柱骨折合并脊髓损伤的效果

Effects of anterior decompression,bone graft and internal fixation in treatment of thoracolumbar spine fracture combined with spinal cord injury

目的:观察前路减压植骨内固定治疗胸腰段脊柱骨折合并脊髓损伤的效果。方法:选取胸腰段脊柱骨折合并脊髓损伤患者77例,随机分为观察组40例和对照组37例。对照组给予后路减压植骨内固定治疗,观察组给予前路减压植骨内固定治疗。比较两组术前和术后3个月的神经功能(ASIA评分)、功能独立性(FIM评分)及脊柱畸形矫正情况。结果:治疗前,两组ASIA评分、FIM评分、Cobb角和伤椎前缘高度比较,差异均无统计学意义(P>0.05),治疗后,两组以上各指标水平均明显改善,且观察组改善幅度大于对照组,差异均有统计学意义(P<0.05)。结论:前路减压植骨内固定术治疗胸腰段脊柱骨折合并脊髓损伤的效果优于后路减压植骨内固定术效果。

Objective： To investigate effects of anterior decompression, bone graft and internal fixation in treatment of thoracolumbar spine fracture combined with sinal cord injury. Methods： 77 cases of thoracolumbar spine fracture combined with spinal cordinjury were selected and divided into observation group （n = 40） and control group （n = 37） according to the admission order. The control group was given posterior decompression, bone graft and internal fixation treatment, while the observation group was treated withanterior decompression, bone graft and internal fixation. The nerve function （ASIA score）, function independence （FIM score） andspinal deformity correction before and 3 months after the operation of the two groups were compared. Results： There were no statisticaldifferences in the ASIA score, FIM score, Cobb angle and anterior vertebral height before the treatment between the two groups （P〉0. 05）. After the treatment, all the above indicators were significantly improved, the improvements of the observation group were greater than those of the control group, and the differences were statistically significant （P〈0. 05）. Conclusions： Anterior decompression,bone graft and internal fixation in the treatment of thoracolumbar spine fracture combined with spinal cord injury is superior to posteriordecompression, bone graft and internal fixation.