经伤椎植入固定螺钉和万向螺钉对胸腰椎骨折手术疗效的影响

Influence of fixation screw and universal screw implanted through injured vertebra on thoracolumbar fracture surgery

目的探讨经伤椎植入固定螺钉和万向螺钉对胸腰椎骨折行后路钉棒内固定手术疗效的影响。方法纳入2014年4月-2017年6月收治的147例胸腰椎骨折患者,按照伤椎固定螺钉的不同,分为固定螺钉组(68例)和万向螺钉组(79例)。所有患者均于术前、术后1周及随访12个月时进行X线和CT检查,测定并比较两组间的伤椎前缘高度及Cobb角变化。结果所有患者均获随访1-3年(平均1.6年),两组患者术前椎体压缩率及Cobb角之间无显著差异(P>0.05);相较于术后1周,固定螺钉组术后12个月的椎体压缩率及Cobb角均无显著丢失(P>0.05),而万向螺钉组术后12个月的上述指标均出现明显丢失现象(P<0.05);术后12个月时,两组患者的椎体压缩率及Cobb角差异有统计学意义(P<0.05)。结论相较于万向螺钉,选用固定螺钉有助于恢复伤椎形态、维持术后的椎体高度和减少Cobb角丢失。

Objective To investigate the effect of fixation screws and universal screws on posterior screw fixation for thoracolumbar fractures.Methods A total of 147 patients with thoracolumbar fractures who were treated in our hospital from April 2014 to June 2017 were divided into fixation screw group(68 cases)and universal screw group(79 cases)according to different fixation screws of injured vertebrae.All patients were examined by X-ray and CT before operation,1 week after operation and 12 months of follow-up.Results All patients were followed up for 1-3 years(average 1.6 years).There were no significant differences in vertebral compression rate and Cobb angle between the two groups(P>0.05).Compared with 1 week after operation,there were no significant differences in loss of vertebral compression rate and Cobb angle in the fixation screw group at 12 months after operation(P>0.05),while the above indicators in the universal screw group were significantly lost at 12 months after operation(P<0.05).At 12 months after operation,there were significant differences in vertebral compression rate and Cobb angle between the two groups(P<0.05).Conclusion Compared with universal screw,fixation screw is helpful to restore the shape of injured vertebra,maintain the height of vertebral body and reduce the loss of Cobb angle.