经伤椎与跨伤椎短节段内固定治疗胸腰椎骨折的临床对比

Clinical Comparison of Short-segment Internal Fixation through Injured Vertebrae and Cross-injured Vertebrae for Thoracolumbar Fracture

目的比较经伤椎与跨伤椎短节段内固定治疗胸腰椎骨折的临床效果。方法选取该院2017年1月—2019年1月期间收治的72例胸腰椎骨折患者,按不同手术方案分为两组,即36例经伤椎短节段内固定治疗患者为经伤椎组,36例跨伤椎短节段内固定治疗患者为跨伤椎组;比较两组患者的围术期指标、伤椎改善情况与并发症。结果经伤椎组、跨伤椎组之间的手术时间,出血量以及住院时间比较,差异无统计学意义(P>0.05)。经伤椎组术后矢状位Cobb角(8.65±2.37)°低于跨伤椎组(14.16±2.51)°,伤椎椎体的前缘比高度(82.36±10.24)%高于跨伤椎组的(71.69±11.75)%,差异有统计学意义(t=9.577、4.108,P<0.05);观察组并发症发生率2.78%低于跨伤椎组的19.44%,差异有统计学意义(χ^2=5.063,P<0.05)。结论与跨伤椎短节段内固定治疗相比,经伤椎短节段内固定治疗胸腰椎骨折能重建椎体高度,获得理想效果,值得应用。

Objective To compare the clinical effects of short-segment internal fixation for the treatment of thoracolumbar fractures through injured vertebrae and straddling vertebrae.Methods A total of 72 patients with thoracolumbar fractures admitted to the hospital from January 2017 to January 2019 were selected and divided into two groups according to different surgical plans,that is,36 patients treated with short-segment internal fixation of the injured vertebrae and complication were classified as the injured vertebral group;36 cases of trans-injured short-segment internal fixation patients belonged to the trans-injured vertebral group;the perioperative indicators and the improvement of the injured vertebrae and compliaction were compared between the two groups.Results There was no statistically significant difference in the operation time,blood loss and hospitalization time between the injured vertebral group and the straddling vertebral group(P>0.05).The sagittal Cobb angle(8.65±2.37)°of the injured vertebrae group was lower than that the trans-injured vertebrae group’s(14.16±2.51)°,and the height of the anterior edge of the injured vertebral body was(82.36±10.24)%,which was higher than the trans-injured vertebrae group’s(71.69±11.75)%,the difference was statistically significant(t=9.577,4.108,P<0.05);the complication rate of the observation group was 2.78%,which was lower than 19.44%of the trans-injury group,the difference was statistically significant(χ^2=5.063,P<0.05).Conclusion Compared with the short-segment internal fixation of the trans-injured vertebra,the short-segment internal fixation of the injured vertebra can reconstruct the height of the vertebral body for the treatment of thoracolumbar fractures and obtain ideal results.It is worthy of application.