基于放射学参数设计脊柱复位器治疗胸腰椎骨折临床应用研究

Clinical Application of Spine Reductor Based on Radiological Parameters in Treatment of Thoracolumbar Fractures

目的:观察基于放射学参数设计脊柱复位器治疗胸腰椎压缩性骨折患者的治疗效果。方法:80例胸腰椎压缩性骨折患者,随机分为无级调节脊柱复位器实验组40例和平卧垫枕保守对照组40例。对比两组患者治疗前、治疗后14d、治疗后60d X线片上的伤椎前缘压缩率、脊柱后凸Cobb’s角、腰背部疼痛视觉模拟评分、Oswsetry功能障碍指数评分。结果:伤椎前缘高度压缩率:实验组和对照组治疗第14d、60d,伤椎前缘高度压缩率与治疗前比较差异均有统计学意义(P<0.05)。两组患者治疗的不同时间节点伤椎前缘高度压缩率的差异存在统计学意义;两组患者伤椎前缘高度压缩率的组间差异存在统计学意义。时间因素与分组因素存在交互效应。脊柱后凸Cobb’s角:实验组和对照组治疗第14d、60d,脊柱后凸Cobb’s角与治疗前比较差异均有统计学意义(P<0.05)。两组患者治疗前后不同时间Cobb’s角的差异存在统计学意义;两组患者脊柱后凸Cobb’s角的组间差异有统计学意义,时间因素与分组因素存在交互效应。腰背部疼痛VAS评分:实验组和对照组治疗第14d、60d,腰背部VAS评分与治疗前比较差异均有统计学意义(P<0.05)。两组患者治疗前后不同时间节点腰背部疼痛VAS评分的差异有统计学意义;两组患者VAS评分的组间差异总体上有统计学意义,时间因素与分组因素存在交互效应。ODI评分结果:实验组和对照组治疗第14d、60d,患者I评分前比较差异均有统计学意义(P<0.05)。两组患者治疗前后不同时间ODI评分的差异有统计学意义;两组患者的VAS评分的组间差异总体上有统计学意义,时间因素与分组因素存在交互效应。结论:胸腰椎椎体压缩骨折应用基于放射学参数设计脊柱复位器治疗,可有效恢复椎体高度,疗效优于平卧垫枕对照组,值得临床推广应用。

Objective To observe the therapeutic effect of spinal reduction device based on radiological parameters in the treatment of thoracolumbar vertebral compression fractures.Methods Eighty patients with thoracolumbar vertebral compression fractures were randomly divided into experimental group of stepless adjustable spinal repositioner(40 cases)and conservative control group of supine pillow(40 cases).The compression rate of the injured vertebral front,Cobb's angle of kyphosis,visual analogue score of low back pain and Oswsetry dysfunction index were compared between the two groups before treatment,14 d after treatment and 60 d after treatment.Results High compression rate of injured vertebral front:The high compression rate of injured vertebral front in the experimental group was significantly lower than those in the control group 14 d after treatment and 60 d after treatment(P<0.05);there was significant difference in the high compression rate of injured vertebral front between the two groups on X-ray films at different time points after treatment;there was significant difference in the high compression rate of injured vertebral front between the two groups on X-ray films.Statistical significance,time factor and grouping factor have interaction effect.Cobb's angle of kyphosis:The Cobb's angle of kyphosis in the experimental group was significantly lower than that in the control group 14 d after treatment and 60 d after treatment(P<0.05);the Cobb's angle of kyphosis in the two groups had statistical significant difference at different time points of X-ray film before and after treatment;the Cobb's angle of kyphosis in the X-ray film of the two groups had statistical significant difference.Inter-factors and grouping factors have interactive effects.VAS score of lumbar and back pain:The VAS scores of lumbar and back pain in the experimental group were significantly lower than that in the control group 14 d after treatment and 60 d after treatment,with statistical significance(P<0.05);the VAS scores of lumbar and back pain in the two groups at different time points before and after treatment were significantly different;the VAS scores of lumbar and back pain in the two groups were statistically different as a whole.There were interaction effects between time factor and grouping factor.ODI score results:ODI scores of the experimental group were significantly lower than those of the control group 14 d after treatment and 60 d after treatment,with statistical significant difference(P<0.05);ODI scores of the two groups at different time points before and after treatment had statistical significant difference;VAS scores of lumbar and back pain of the two groups had statistical significant difference,and there was no interaction between time factors and grouping factors.Conclusion Spinal reduction device based on radiological parameters can effectively restore the vertebral height of thoracolumbar vertebral compression fracture,and the curative effect is better than that of pillow control group.It is worthy of clinical application.