不同入路方式减压治疗胸腰段骨折合并脊髓损伤的疗效

Therapeutic effect of different approach methods of decompression in the treatment of thoracolumbar fracture combined with spinal cord injury

目的探讨不同入路方式减压治疗胸腰段骨折合并脊髓损伤的临床疗效。方法选取2015年4月至2017年11月我院96例胸腰段骨折合并脊髓损伤患者为研究对象,根据不同手术入路方式将其分为A、B两组,每组48例。A组患者行后路减压治疗,B组患者行前路减压治疗,比较两组患者的手术情况、触觉评分、运动评分、伤椎高度及Cobb角。结果两组患者的住院时间比较,差异无统计学意义(P>0.05);A组患者的手术时间短于B组,术中出血量少于B组,植骨融合时间长于B组(P<0.05)。术后,两组患者的触觉评分、运动评分、伤椎高度及Cobb角均升高,且B组均显著高于A组(P<0.05)。结论在胸腰段骨折合并脊髓损伤手术中,采用后路减压的手术时间及术中出血量较少,但前路减压在改善椎体功能、解除脊髓受压方面较后路减压更具优势。

Objective To explore clinical efficacy of different approache methods of decompression in the treatment ofthoracolumbar fracture and spinal cord injury. Methods A total of 96 patients with thoracolumbar fracture and spinal cordinjury from April 2015 to November 2017 were selected as study subjects. According to the different approaches methods, allpatients were divided into group A and group B, with 48 cases in each group. The group A was treated with posterior-approach decompression, and the groupB was treated with anterior-approach decompression. The surgical conditions, tactilescores, exercise scores, height of injured vertebrae and Cobb angle were compared between the two groups. Results There wasno statistical difference in hospitalization time between the two groups （P〉0.05）. The operation time in the group A wasshorter than that in the group B, intraoperative blood loss was less than that in the group B, and the bone graft fusion time inthe group A was longer than that in the group B（P〈0.05）. After operation, the scores of tactile and exercise, height of theinjured vertebra and Cobb angle of the two groups increased, and those in the groupB were significantly higher than thegroup A（P〈0.05）. Conclusion The posterior -approach decompression has shorter operation time and less amount ofintraoperative blood loss, but the anterior-approach decompression is more advantageous in improving vertebral functionand relieving spinal cord compression.