腰椎外伤爆裂性骨折手术中置钉对术后远期神经功能复原的影响

The Influence of Screw Placement in the Operation of Burst Fracture of Lumbar Spine Injury on the Longterm Recovery of Postoperative Nerve Function

目的探讨腰椎外伤爆裂性骨折手术中置钉对术后远期神经功能复原的影响。方法收集我院胸腰椎B型骨折的患者,分为研究组和对照组。研究组予置钉单椎间椎弓根螺钉复位,对照组予跨伤椎短节段固定。对比两组骨折类型及受伤原因;两组手术时间、术中出血量及术后医院卧床时间;两组手术前及手术后6月椎体前缘高度、后凸Cobb角及矢状面指数。结果两组骨折类型及受伤原因结果比较无差异(P>0.05);通过对比手术时间、术中出血量及术后医院卧床时间三项指标,研究组和对照组数据分别为(105.34±16.38)min、(204.35±43.63)mL、(14.35±3.63)d、(75.69±9.14)min、(96.28±24.14)mL、(10.24±1.82)d,研究组三项数据均少于对照组,两组结果比较有差异(P<0.05);通过对比椎体前缘高度、后凸Cobb角及矢状面指数三项指标,研究组和对照组术前指标分别为(53.25±15.28)%、(17.25±4.21)°、(19.63±4.15)°、(53.61±15.31)%、(17.31±4.19)°、(19.62±3.99)°,两组结果比较无差异(P>0.05);研究组和对照组手术后6月指标分别为(93.25±8.25)%、(3.56±1.42)°、(13.57±2.12)°、(85.33±7.65)%、(3.94±1.59)°、(14.89±4.15)°,两组结果比较有差异(P<0.05)。结论本文中研究组所采取的手术方案优势在于创伤小,手术后恢复快,用于腰椎外伤爆裂性骨折手术后优势大于跨伤椎短节段固定术。

Objective To investigate the effect of screw placement in the operation of lumbar burst fracture on the long-term recovery of neurological function. Methods The patients with type B thoracolumbar fractures in our hospital were collected and divided into study group and control group. The study group was treated with single intervertebral pedicle screw reduction, while the control group was treated with short segment fixation across the injured vertebrae. The fracture types and injury causes of the two groups were compared;the operation time, intraoperative blood loss and postoperative hospital bed time of the two groups;the anterior vertebral height, kyphosis Cobb angle and sagittal index of the two groups before and 6 months after operation were compared. Results There was no difference in fracture types and injury causes between the two groups(P>0.05);there were 21 cases of high falling injury, 16 cases of traffic accident, 13 cases of heavy object injury in the study group, 23 cases of high falling injury, 12 cases of traffic accident and 15 cases of heavy object injury in the control group, and the results showed no difference(P>0.05) The operation time, intraoperative blood loss and postoperative hospital stay time were(105.34±16.38)minutes,(204.35±43.63)mL,(14.35±3.63)days,(75.69±9.14)minutes,(96.28±24.14)mL,(10.24±1.82)days in the study group and the control group, respectively. The three data of the study group were less than those of the control group, and there were differences between the two groups(P<0.05) The preoperative indexes of Cobb angle and sagittal index in the study group and the control group were(53.25±15.28)%,(17.25±4.21)° and(19.63±4.15)°,(53.61±15.31)%,(17.31±4.19)° and(19.62±3.99)° respectively, and there was no difference between the two groups(P>0.05);6 months after operation, the indexes of study group and control group were(93.25±8.25)%,(3.56±1.42)° and(13.57±2.12)°,(85.33±7.65)%,(3.94±1.59)° and(14.89±4.15)° respectively, and the results of the two groups were different(P<0.05). Conclusion The advantages of the operation scheme adopted by the research group in this paper are small trauma and quick recovery after operation. The advantages of the operation scheme for lumbar burst fracture after operation is greater than that of short segment fixation across the injured vertebrae.