评价后路经椎弓根钉内固定治疗胸腰椎骨折合并后方韧带复合体损伤的早期疗效

Evaluation on the early efficacy of posterior transpedicular screw internal fixation for thoracolumbar fracture with posterior ligament complex injury

目的评价后路经椎弓根钉内固定治疗胸腰椎骨折合并后方韧带复合体(PLC)损伤的早期疗效。方法 80例胸腰椎骨折合并后方韧带复合体损伤患者,均采用后路经椎弓根钉内固定手术治疗,比较治疗前后腰背痛视觉模拟评分法(VAS)评分、Cobb角及椎体前缘高度、椎体后缘高度、椎管面积为正常椎体的百分数。结果治疗前腰背痛VAS评分为(7.1±1.0)分,治疗后腰背痛VAS评分为(2.0±0.5)分;治疗后腰背痛VAS评分低于治疗前,差异有统计学意义(P<0.05)。治疗后椎体前缘高度为正常椎体的百分数(98.2±4.0)%、椎体后缘高度为正常椎体的百分数(98.7±5.0)%、椎管面积为正常椎体的百分数(94.0±4.4)%、Cobb角(3.8±1.0)°优于治疗前的(75.0±3.3)%、(95.0±4.2)%、(82.4±3.0)%、(30.2±2.0)°,差异有统计学意义(P<0.05)。结论对胸腰椎骨折合并后方韧带复合体损伤患者实施后路经椎弓根钉内固定手术治疗的早期临床疗效较优。

Objective To evaluate the early efficacy of posterior transpedicular screw internal fixation for thoracolumbar fracture with posterior ligament complex(PLC)injury.Methods A total of 80 patients with thoracolumbar fracture and posterior ligament complex injury all received posterior transpedicular screw fixation for treatment,and the visual analogue scale(VAS)score,Cobb angle,percentage of normal vertebrae in anterior height,posterior height and vertebral canal area before and after treatment.Results Before treatment,patients had low back pain VAS score as(7.1±1.0)points,and(2.0±0.5)points after treatment.After treatment,patients had lower low back pain VAS score than those before treatment,and the difference was statistically significant(P<0.05).After treatment,patients had percentage of normal vertebrae in anterior height as(98.2±4.0)%,posterior height as(98.7±5.0)%,vertebral canal area as(94.0±4.4)%,and Cobb angle as(3.8±1.0)°,which were all better than(75.0±3.3)%,(95.0±4.2)%,(82.4±3.0)%and(30.2±2.0)°before treatment.Their difference was statistically significant(P<0.05).Conclusion Posterior transpedicle screw internal fixation shows better clinical efficacy for the treatment of thoracolumbar fracture with posterior ligament complex injury.