胸腰段脊柱骨折内固定术后对运动协调的影响

Effect of internal fixation surgery for thoracolumbar spinal fractures on motion coordination

目的分析胸腰段脊柱骨折内固定术后患者不同步行速度下的胸椎、腰椎、骨盆及下肢的水平旋转幅度(TRA)及其节段间的旋转的幅度(RFP),探讨脊柱僵硬程度和步态水平旋转协调性之间的关系。方法比较40名胸腰段脊柱骨折内固定术后患者(治疗组)和40名健康志愿者(对照组)的步态运动,计算其胸廓、腰椎、骨盆及下肢TRA,胸廓、腰椎、骨盆各个节段间RFP。结果治疗组患者,胸廓、腰椎、骨盆和下肢TRA随步行速度提高而增加,与对照组比较的差异有统计学意义(P<0.01);骨盆与腰椎节段间RFP,腰椎和胸廓节段间RFP和骨盆和胸廓节段间RFP,均随速度提高而增加,与对照组比较的差异有统计学意义(P<0.01)。结论胸腰段脊柱骨折内固定术后脊柱僵硬,胸廓、腰椎、骨盆及下肢TRA及其节段间RFP均明显减少,运动协调性下降。

Objective To investigate the relationship between degree of spinal stiffness and transverse rotation coordination of gait through analyzing the transverse rotation amplitude(TRA)and relative Fourier phase(RFP)of the thoracic vertebra,lumbar vertebra,pelvis and lower extremities of patients receiving internal fixation surgery for thoracolumbar spinal fractures at different walking speeds.Methods Gait motions of 40 healthy volunteers(control group)and 40 patients receiving internal fixation surgery for thoracolumbar spinal fractures(treatment group)were compared.The TRA of the thorax,lumbar vertebra,pelvis and lower extremities,and the RFP between segments were calculated.Results The TRA of the thorax,lumbar vertebra,pelvis and lower extremities increased with the walking speed,and the difference between the two groups was statistically significant(P<O.01).The RFP between pelvic and lumbar vertebra,the RFP between lumbar vertebra and thorax,and the RFP between pelvic and thorax all increased with the waking speed.The difference between the treatment group and the control group was statistically significant(P<0.01).Conclusion After the internal fixation surgery for thoracolumbar spinal fractures stiff spines are observed.The TRA as well as the RFP of thorax,lumbar vertebra,pelvis and lower extremities significantly decreased,and the motion coordination also decreased.