短节段椎弓根钉内固定治疗非相邻型多节段脊柱骨折的疗效评价

Evaluation on the Efficacy of Short-segment Pedicle Instrumentation in the Treatment of Multi-level Non-continuous Spinal Fractures

目的分析短节段椎弓根钉内固定治疗非相邻型多节段脊柱骨折(MNSF)的临床疗效。方法 43例MNSF患者根据自我意愿分为对照组27例(行后路长节段椎弓根钉内固定治疗)与观察组26例(行后路短节段椎弓根钉内固定治疗),观察两组手术情况、Cobb角角度、Frankel脊椎损伤功能分级及日本骨科协会(JOA)评分情况。结果与对照组比较,观察组手术时间及术中出血量明显改善,差异有统计学意义(P<0.05)。术后1个月,两组Cobb角角度较术前明显缩小,JOA评分明显增加,但观察组缩小及增加幅度均大于对照组,差异有统计学意义(P<0.05)。术后1个月,观察组脊椎损伤功能改善情况明显优于对照组,差异有统计学意义(P<0.05)。结论与后路长节段椎弓根钉内固定相比,短节段椎弓根钉内固定治疗MNSF更有利于患者神经功能与腰椎功能的恢复。

OBJECTIVE To explore the clinical efficacy of short-segment pedicle instrumentation（SSPI） in the treatment of multi-lev-el non-continuous spinal fractures（MNSF）. METHODS According to the patients＇ willing, 43 cases of MNSF were divided into con-trol group（n=27, undergoing posterior long-segment pedicle instrumentation） and observation group（n=26, undergoing posterior SS-PI）. The conditions of operation, Cobb angle, functional classification of Frankel spinal cord injury and Japanese Orthopaedic Associa-tion（JOA） scores were all observed in two groups. RESULTS The operation time and amount of intraoperative bleeding were improvedobviously in observation group when compared to those in control group（P〈0.05）. 1 month after operation, the Cobb angle de-creased, while JOA scores increased in two groups when compared to those before operation, but the decreased and increased degreesof observation group were larger（P〈0.05）. 1 month after operation, the improvement condition of spinal cord injury in observationgroup was superior to that in control group, and significant difference was shown（P〈0.05）. CONCLUSION Compared with posteriorlong-segment pedicle instrumentation, SSPI was more conductive to recovery of neurological function and lumbar function for patientswith MNSF.