短节段椎弓根钉固定手术治疗急性脊柱损伤效果观察

Clinical effects of short segment pedicle screw fixation on acute spinal injury

目的探讨短节段椎弓根钉固定手术治疗急性脊柱损伤的临床效果。方法选择35例急性脊柱损伤患者作为研究对象,所有患者均实施短节段椎弓根钉固定手术治疗。观察患者术前和术后1 h及1个月的椎体前后缘压缩高度、椎管占位率以及Cobb角间的距离,同时观察患者术后1个月的脊髓神经功能改善效果。结果 35例患者术后1 h及1个月的椎体前后缘压缩高度、椎管占位率以及Cobbs角间的距离均低于术前,差异均有统计学意义(P<0.05);术后1 h及1个月患者的椎体前后缘压缩高度、椎管占位率及Cobb角间的距离比较,差异未见统计学意义(P>0.05);脊髓神经功能恢复评分主要分为A、B、C、D、E五个等级,术后1个月,A、B、C、D级患者的比例低于术前,差异有统计学意义(P<0.05),E级患者的比例高于术前,差异有统计学意义(P<0.05)。结论短节段椎弓根钉固定手术治疗急性脊柱损伤患者临床效果较好,能够降低椎体前后缘压缩高度、椎管占位率及Cobb角间的距离,改善脊贿神经功能,推荐临床使用。

Objective To investigate the clinical effects of short segment pedicle screw fixation on patients with acute spinal injury. Methods A total of 35 patients with acute spinal injury were select- ed as the research objects. All patients were treated by short segment pedicle screw fixation. The com- pression height of anterior and posterior margin of vertebral body, the occupation rate of spinal canal and the distance between the Cobb angles before and after 1 h and 1 month were observed. At the same time, the improvement of spinal nerve function in 1 month after the operation was observed. Results The com- pression height of anterior and posterior margin of vertebral body, the occupation rate of spinal canal and the distance between the Cobb angles were all lower in 35 patients after 1 h and 1 month than before the operation, and the differences were significant （P 〈 0. 05 ）. There was no significant difference in the compression height of the anterior and posterior margin of the vertebral body, the occupation rate of spinal canal and the distance between the Cobb angles in patients l h and 1 month after the operation （P 〉 0. 05 ）. The neurological function was divided into five grades ： A, B, C, D and E. One month after the operation, the proportion of patients with A, B, C, D level was lower than that before operation, the difference was significant （P 〈 0. 05 ）, the proportion of patients with E level was higher than that before operation, the difference was significant （P 〈 0.05）. Conclusions In the treatment of patients with a- cute spinal injury, short segment pedicle screw fixation has good clinical effects, it can reduce the com- pression height of the anterior and posterior margin of vertebral body, the occupation rate of spinal canal and the distance between the Cobb angles, which is worthy of application in clinical practice.