后路复位固定椎体间植骨融合治疗老年胸腰椎骨折脱位疗效及对患者神经功能的影响

Effect of posterior fixation and interbody fusion in the treatment of thoracolumbar fractures and dislocation in elderly patients and its effect on neurological function

目的:研究胸腰椎骨折脱位的老年患者采用后路复位固定联合椎体间植骨融合治疗对患者神经功能的影响及临床效果。方法:选择126例胸腰椎骨折脱位老年患者作为研究对象,按随机数字表法分为两组各63例。对照组患者仅采用后路复位固定术治疗,观察组患者在上述基础上联合椎体间植骨融合治疗。观察两组患者手术情况、胸腰椎恢复情况以及神经功能情况。结果:两组患者术中出血量无统计学差异(P>0.05);观察组手术时间明显长于对照组(P<0.05)。术前两组患者椎体高度、Cobb角以及VAS评分无统计学差异(P>0.05);术后观察组椎体高度、Cobb角以及VAS评分均优于对照组(P<0.05)。术前两组患者神经功能Frankel分级无差异(P>0.05);术后观察组神经功能Frankel分级优于对照组(P<0.05)。结论:后路复位固定联合椎体间植骨融合对老年胸腰椎骨折脱位患者具有较好疗效,可改善患者神经功能,有效恢复伤锥。

ObjectiveTo study the effect of posterior reduction and fixation combined with interbody fusion on the neurological function of the elderly patients with thoracolumbar fracture and dislocation. Methods：According to the random number table method, two groups were divided into 63 cases. The control group was treated by posterior reduction and fixation, while the observation group was treated with interbody bone graft fusion. The operation condition, recovery of thoracolumbar vertebrae and neurological function of the two groups were observed. Results：There was no difference in bleeding volume between the two groups（ P 〉0.05）; the operative time in the observation group was significantly longer than that in the control group（ P 〈0.05）. There was no difference in vertebral height, Cobb angle and VAS score between the two groups before operation, and（ P 〉0.05）. The vertebral height, Cobb angle and VAS score in the observation group were better than those of the control group（ P 〈0.05）. There was no difference in Frankel grade of nerve function between the two groups before operation（ P 〉0.05）; after operation, the Frankel grading of nerve function in observation group was better than that in control group（ P 〈0.05）. Conclusion： posterior reduction and fixation combined with interbody interbody fusion has a good effect on the elderly patients with thoracolumbar fracture and dislocation, improving the nerve function of the patients and restoring the wound cones effectively. It is worthy of clinical application and popularization.