前后路减压治疗胸腰段脊柱骨折合并脊髓神经损伤临床分析

Clinical analysis of anterior and posterior decompression for thoracolumbar spine fracture combined with spinal nerve injury

目的探讨前后路减压治疗胸腰段脊柱骨折合并脊髓神经损伤的效果。方法选取南阳市骨科医院2014-02-2015-08收治的胸腰段脊柱骨折合并脊髓神经损伤患者71例,随机分为对照组35例和观察组36例,对照组患者予以后路减压手术治疗,观察组患者实施前路减压手术治疗,观察2组患者治疗效果。结果2组手术时间、术中出血量、住院时间对比差异有统计学意义(P<0.05);2组术前触觉评分、运动评分、伤椎高度、Cobb’s角差异无统计学意义(P>0.05),术后观察组各项指标均明显优于对照组(P<0.05);观察组患者满意度明显高于对照组(P<0.05)。结论前路减压治疗胸腰段脊柱骨折合并脊髓神经损伤患者综合优势更突出,但要注意做好术前准备,最大程度缩短手术时间以减轻患者疼痛,增强治疗效果。

Objective To investigate the effect of anterior and posterior decompression on thoracolumbar spine fracture combined with spinal nerve injury.Methods Seventy-one patients with thoracolumbar spine fractures and spinal cord injury were enrolled in Nanyang City Orthopaedic Hospital from December 24,2015 to September 2008.They were numbered according to the order of admission and were divided into control group(35 cases) and observation group by random number table.For example,patients in the control group underwent posterior decompression surgery.Patients in the observation group underwent anterior decompression surgery.The therapeutic effects of the two groups were compared and clinically controlled.Results There were significant differences in the operation time,intraoperative blood loss and hospitalization time between the two groups(P<0.05).There was no significant difference between the two groups in preoperative tactile score,exercise score,injured vertebra height and Cobb’s angle(P>0.05),the indexes of the postoperative observation group were significantly better than the control group(P<0.05);the treatment satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion The advantages of anterior decompression for patients with thoracolumbar spine fracture and spinal cord injury are more prominent,but it is necessary to pay attention to preoperative preparation to minimize the operation time to reduce the pain and enhance the treatment effect.