后路短节段椎弓根螺钉固定对单节段胸腰椎爆裂性骨折患者术后伤椎前缘高度及Cobb’s角的影响

Effect of Posterior Short-Segment Pedicle Screw Fixation on the Height of the Injured Anterior Border and Cobb’s Angle in Patients with Single-Segment Thoracolumbar Burst Fracture

目的 探究后路短节段椎弓根螺钉固定对单节段胸腰椎爆裂性骨折患者术后伤椎前缘高度及Cobb's角的影响。方法 选取2009年7月至2015年6月我院单节段胸腰椎爆裂性骨折患者43例,均行后路短节段椎弓根螺钉固定治疗。统计43例患者手术及随访情况,并对比术前、术后1周、末次随访伤椎前缘高度、Cobb's角、疼痛程度(VAS)及手术前后脊髓神经功能恢复情况。结果 43例患者手术均顺利完成,且术中未出现并发症;所有患者均获得随访,随访时间12~95(48.12±18.15)个月,随访过程中仅2例切口浅表性感染,1例螺钉穿透椎弓根内侧皮质,术后并发症发生率为6.98%;43例患者术后1周及末次随访伤椎前缘高度较术前高,Cobb's角及VAS评分均较术前低(P<0.05),末次随访伤椎前缘高度、VAS评分较术后1周低,Cobb's角较术后1周高(P<0.05);43例患者末次随访神经功能优于术前(P<0.05)。结论 对单节段胸腰椎爆裂性骨折患者行后路短节段椎弓根螺钉固定治疗,可有效促进患者伤椎前缘高度、Cobb's角及脊髓神经功能恢复,显著缓解术后疼痛程度,且安全性较高。

Objective To investigate the effect of posterior short-segment pedicle screw fixation on the height of the injured anterior border and Cobb's angle in patients with single-segment thoracolumbar burst fracture.Methods From July 2009 to June 2015,43 patients with single-segment thoracolumbar burst fractures were enrolled in our hospital.All patients underwent posterior short-segment pedicle screw fixation.The operation and follow-up of 43 patients were compared,and the preoperative,postoperative 1 week,last follow-up of the vertebral pedicle height,Cobb's angle,pain level(VAS)and spinal nerve function recovery before and after surgery were compared.Results All the 43 patients underwent surgery successfully,and no complications occurred during the operation.All patients were followed up for 12 to 95(48.12±18.15)months.During the follow-up,only 2 cases had superficial infection and 1 case of the screw penetrated the medial cortex of the pedicle.The postoperative complication rate was 6.98%(3/43).The height of the anterior border of the injured vertebra was higher than that of the preoperative at one week and the last follow-up.The Cobb's angle and VAS score both compared with preoperativewere low(P<0.05),the height of the anterior edge of the injured vertebrae and the VAS score were lower than that of the first week after operation.The Cobb's angle was higher than that of the first week after operation(P<0.05).The neurological function of the 43 patients was better than the last follow-up.Preoperative(P<0.05).Conclusion Posterior short-segment pedicle screw fixation for patients with single-segment thoracolumbar burst fracture can effectively promote the height of the injured anterior border,Cobb's angle and spinal nerve function recovery,and significantly relieve postoperative pain and havehigh security.