跨伤椎固定与经伤椎固定治疗胸腰椎骨折的临床效果研究

Clinical effect of intervertebral fixation and injured vertebral fixation in the treatment of thoracolumbar vertebral fractures

目的探讨跨伤椎固定与经伤椎固定治疗在胸腰椎骨折治疗的临床效果。方法 2015年5月~2018年3月,随机选取我院收治的胸腰椎骨折患者92例作为研究对象,根据其入院序号奇偶数按比例(1∶1)划分为对照组和观察组,每组患者46例,对照组给予跨伤椎固定治疗,观察组行经伤椎固定治疗,观察两组患者治疗前后椎体前缘高度、椎体后凸Cobb角、疼痛评分、术中情况和术后并发症发生情况。结果观察组患者手术时间长于对照组且差异有统计学意义(P <0.05),但术中出血量组间比较差异无统计学意义(P> 0.05);治疗前两组患者椎体前缘高度、椎体后凸Cobb角疼痛评分对比差异无统计学意义(P> 0.05),治疗2个月后上述指标均明显改善,且观察组椎体前缘高度较大,椎体后凸Cobb角较小,VAS评分较低(P <0.05);治疗2个月后,观察组患者椎体高度丢失、术后感染、螺钉脱出发生率分别为2.17%、6.51%和4.34%,均低于对照组8.68%、10.85%和10.85%,但组间差异无统计学意义(P> 0.05)。结论针对胸腰椎骨折患者,给予经伤椎固定治疗效果理想,可促进患者椎体前缘高度、椎体后凸Cobb角快速恢复,且患者疼痛程度较轻,术后并发症发生率较低,具有较高的安全性,值得进一步推广。

Objective To investigate the clinical effects of intervertebral fixation and injured vertebral fixation in the treatment of thoracolumbar vertebral fractures. Methods From May 2015 to March 2018, ninety-two patients with thoracolumbar vertebral fractures who treated in our hospital were randomly selected as the study subjects. All cases were divided into control group and observation group according to the odd and even number of hospital admissions（1 ： 1）, 46 cases in each group. The control group was treated with intervertebral fixation, while the observation group was treated with injured vertebral fixation, and the anterior vertebral height, Cobb angle of vertebral knee, pain score, intraoperative conditions and postoperative complications occurred of two groups were compared. Results The operation time of the observation group was longer than that of the control group and the difference was statistically signifieant（P 〈 0.05）, but there was no significant difference in the amount of bleeding between the two groups（P 〉 0.05）. There was no significant difference in the anterior vertebral height and Cobb angle pain score of vertebral knee between the two groups before treatment（P 〉 0.05）. After 2 months of treatment, the above indicators were significantly improved, and anterior vertebral height was higher, the Cobb angle of vertebral knee was smaller, and the VAS score was lower in the observation group（P 〈 0.05）. After 2 months of treatment, the incidence of anterior vertebral height loss, postoperative infection and screw removal in the observation group were 2.17%, 6.51% and 4.34% respectively, which were lower than those in the control group（8.68%, 10.85% and 10.85%）, but there was no significant difference between the two groups（P 〉 0.05）. Conclusion For patients with thoraeolumbar vertebral fi＇aetures, the effect of injured vertebral fixation is satisfactory, which can promote the rapid recovery of anterior vertebral height, Cobb angle of vertebral knee and the patient＇s pain is mild, and the incidence of postoperative complications is low, with high security, it is worth further promotion.