跨伤椎固定和经伤椎固定在胸腰段脊柱骨折治疗中的临床比较

Clinical Comparison of Trans-spine Fixation and Transsphenoidal Fixation in the Treatment of Thoracolumbar Spine Fractures

目的:比较跨伤椎固定和经伤椎固定在胸腰段脊柱骨折治疗中的临床效果。方法:选取72例笔者所在医院2017年7月-2018年9月收治的胸腰段脊柱骨折患者,两组患者均采用手术治疗,其中经伤椎固定手术的为观察组,跨伤椎固定手术的为对照组,比较两组治疗效果、手术相关指标、治疗前后伤椎压缩率和后凸Cobb角,随访10个月观察椎体高度丢失和后凸Cobb角丢失情况。结果:观察组的总有效率为94.44%,高于对照组的75.00%,差异有统计学意义(P<0.05)。观察组手术出血量、手术时间、术后引流量、VAS评分等分别为(265.8±27.6)ml、(90.6±8.2)min、(146.8±22.4)ml、(1.3±0.3)分,前三项数据均要高于对照组(P<0.05),VAS评分两组差异无统计学意义(P>0.05)。观察组的治疗前后伤椎压缩率和后凸Cobb角分别为(44.2±4.5)%、(3.3±1.1)%和(22.4±2.5)°、(4.5±0.6)°,治疗后的数据与对照组相比,差异有统计学意义(P<0.05)。观察组随访椎体高度丢失和后凸Cobb角丢失情况(1.2±0.4)mm,(0.7±0.2)°,均要低于对照组的(5.7±0.6)mm,(3.9±0.6)°,差异有统计学意义(P<0.05)。结论:跨伤椎固定和经伤椎固定在胸腰段脊柱骨折治疗中的临床效果比较,可以发现经伤椎固定的效果更高,值得进一步应用推广。

Objective:To compare the clinical effects of trans-sacral fixation and transsphenoidal fixation in the treatment of thoracolumbar spine fractures.Method:During the study,72 patients with thoracolumbar spine fractures who were admitted from July 2017 to September 2018 were selected.The patients in both groups were treated by surgery.Among them,the fixed operation of transsphenoidal fixation was the observation group,and the operation of trans-spine fixation was the control group.The therapeutic effects,surgical related indexes,compression rate and kyphosis Cobb angle before and after treatment,and vertebral height loss and kyphosis Cobb angle loss of following 10 months were observed.Result:The therapeutic effect of the observation group was 94.44%,which was higher than 75.00%of the control group(P<0.05).The amount of surgical bleeding,operation time,postoperative drainage volume,and VAS score in the observation group were(265.8±27.6)ml,(90.6±8.2)min,(146.8±22.4)ml,and(1.3±0.3)points,respectively.The first three data were higher than the control group(P<0.05),while the VAS scores were not statistically significant(P>0.05).The compression rate and kyphosis Cobb angles of the observation group before and after treatment were(44.2±4.5)%,(3.3±1.1)%,and(22.4±2.5)°,(4.5±0.6)°,respectively.The data after treatment which compared with the control group were statistically significant(P<0.05).Loss of vertebral body height and kyphosis Cobb angle loss in the observation group were(1.2±0.4)mm,(0.7±0.2)°,they were lower than(5.7±0.6)mm,(3.9±0.6)°in the control group,the differences were significant(P<0.05).Conclusion:The clinical effect of trans-spine fixation and transsphenoidal fixation in the treatment of thoracolumbar spine fractures can be found that the effect of transsphenoidal fixation is higher and worthy of further application.