两种不同内固定方式治疗胸腰椎单一椎体骨折的临床效果

Clinical effect of two different internal fixation methods for single thoracolumbar vertebral fracture

目的比较经伤椎椎弓根内固定术与跨伤椎内固定术治疗胸腰椎单一椎体骨折的临床效果。方法选取2014年1月至2016年1月我院收治的73例胸腰椎单一椎体骨折的患者为研究对象,按照手术方式将其分为跨伤椎组(n=39,跨伤椎内固定术)和经伤椎组(n=34,经伤椎椎弓根内固定术)。比较两组手术时间、术中出血量、住院时间、手术前、后Cobb角及JOA评分。结果两组患者手术时间、术中出血量及住院时间比较,差异无统计学意义(P>0.05)。与术前相比,两组患者术后1周、术后12个月Cobb角显著减小,且经伤椎组患者显著小于跨伤椎组,差异有统计学意义(P<0.05)。术后12个月,两组患者术后JOA评分均显著升高,差异有统计学意义(P<0.05);两组患者术后12个月JOA评分比较,差异无统计学意义(P>0.05)。结论经后路伤椎椎弓根内固定术能够更好地维持脊柱矫正度,是治疗胸腰椎单一椎体骨折较好的选择。

Objective To compare the clinical effects of traumtic vertebral internal fixation and trans-traumatic vertebrae internal fixation in the treatment of single thoracolumbar vertebral fracture.Methods A total of 73 patients with single thoracolumbar vertebral fracture from Jan 2014 to Jan 2016 were selected as study objects.According to the surgical method,the patients were divided into trans-traumatic vertebral group (n=39,trans-traumatic vertebrae internal fixation) and traumatic vertebral group (n=34,traumtic vertebral internal fixation).The operation time,intraoperative bleeding volume,hospitalization time,preoperative and postoperative Cobb angle and JOA scores were compared between the two groups.Results There were no significant differences in operation time,intraoperative bleeding volume and hospitalization time between the two groups (P>0.05).Compared with preoperative,the Cobb angle of the two groups decreased significantly at 1 week and 12 months after operation,and those in the trans-traumatic vertebral group were significantly smaller than the traumatic vertebral group(P<0.05).After operation of 12 months,JOA scores of the two groups increased significantly (P<0.05).There was no significant difference in JOA score between the two groups at 12 months after operation (P>0.05).Conclusion Posterior traumtic vertebral internal fixation can better maintain spinal correction,which is a better choice for the treatment of single thoracolumbar vertebral fracture.