经伤椎内固定对胸腰段脊柱骨折复位效果及椎管侵占率的影响

Effect of Cross-Vertebral Internal Fixation on the Reduction of Thoracolumbar Spinal Fractures and the Spinal Canal Invasion Rate

目的研究探讨经伤椎内固定对胸腰段脊柱骨折复位效果及椎管侵占率的影响。方法选取2014年5月至2018年5月泗阳县人民医院骨科收治的114例胸腰段脊柱骨折患者作为研究对象,并按照随机数表法将其随机分为观察组(59例)与对照组(55例),其中观察组患者采用经伤椎内固定治疗,对照组患者采用跨伤椎内固定治疗,对比两组患者手术相关指标及矢状位Cobb角、伤椎前缘高度和椎管侵占率变化情况。结果观察组患者手术时间明显长于对照组(t=4.011,P=0.000),术中出血量明显多于对照组(t=11.470,P=0.000),首次下床时间及住院时间与对照组无明显差异(P均>0.05);术后3、6、12个月观察组患者矢状位Cobb角均明显小于对照组(t=30.600、34.820、27.130,P均=0.000),伤椎前缘高度均明显大于对照组(t=19.150、25.130、27.930,P均=0.000),椎管侵占率均明显低于对照组(t=22.080、20.680、23.000,P均=0.000)。结论与跨伤椎内固定相比,经伤椎内固定能够更好地重建椎体生理高度,降低椎管侵占率,矫正脊柱畸形,恢复脊柱正常解剖结构,临床应用价值较高。

Objective To explore the effect of cross-vertebral internal fixation on the reduction of thoracolumbar spinal fractures and spinal canal invasion rate.Methods 114 patients with thoracolumbar spine fractures,admitted to the Department of Orthopedics,People’s Hospital of Siyang from May 2014 to May 2018,were selected as research subjects and then divided,according to random number table,into an observation group(59 cases) and a control group(55 cases).Patients in the observation group were treated with cross-vertebral internal fixation while patients in the control group were treated with by-vertebral internal fixation.Surgery-related indicators,Cobb angle in sagittal plane,the height of vertebral anterior edge and spinal canal invasion rate were compared between the two groups.Results The surgical time in the observation group was significantly longer than the control group(t=4.011,P=0.000),the intraoperative blood loss in the observation group was significantly more in volume than the control group(t=11.470,P=0.000),and no significant difference was observed in time of first ambulation and duration of hospitalization(all P> 0.05);the Cobb angle in sagittal plane in 3,6 and 12 months after surgery in the observation group was significantly smaller than the control group(t=30.600,34.820,27.130,all P=0.000),the vertebral anterior edge in the observation group were significantly higher than the control group(t=19.150,25.130,27.930,all P=0.000),and the spinal canal invasion rate in the observation group was significantly lower than the control group(t=22.080,20.680,23.000,all P=0.000).Conclusion Compared with by-vertebral internal fixation,cross-vertebral internal fixation has its own advantage in reconstructing the physiological height of the vertebral body,reducing spinal canal invasion rate,correcting spinal deformity and restoring normal anatomical structure of spine,so it has higher clinical application value.