钉棒系统内固定对胸腰段爆裂性骨折患者脊柱稳定性的影响

Study the effect of screw-rod system internal fixation on spinal stability in patients with thoracolumbar burst fracture

目的研究钉棒系统内固定对胸腰段爆裂性骨折(TBF)患者脊柱稳定性的影响。方法54例胸腰段爆裂性骨折患者,均实施钉棒系统内固定治疗。比较患者手术前后Cobb角、椎体前后缘高度比值及椎体前后缘高度。结果术前,患者Cobb角为(27.88±11.22)°,术后为(5.36±1.88)°;术后Cobb角小于术前,差异有统计学意义(P<0.05)。术前,患者椎体后缘高度比值为(89.35±2.33)%,椎体前缘高度比值为(54.13±13.33)%;术后1、3、6个月,患者椎体后缘高度比值分别为(90.64±3.66)%、(91.33±4.55)%、(90.35±2.56)%,椎体前缘高度比值分别为(91.24±4.33)%、(92.22±2.34)%、(92.66±2.35)%;术后1、3、6个月,患者椎体后缘高度比值和椎体前缘高度比值均大于术前,差异有统计学意义(P<0.05);术后3、6个月,患者椎体后缘高度比值和椎体前缘高度比值与术后1个月比较,差异无统计学意义(P>0.05);术后6个月,患者椎体后缘高度比值和椎体前缘高度比值与术后3个月比较,差异无统计学意义(P>0.05)。术前,患者椎体前缘高度为(19.88±3.22)mm,椎体后缘高度为(32.33±1.33)mm;术后3、6个月,患者椎体前缘高度分别为(34.89±2.34)、(34.97±2.35)mm,椎体后缘高度分别为(35.22±0.84)、(34.90±0.86)mm;术后3、6个月,患者椎体前缘高度和椎体后缘高度均大于术前,差异有统计学意义(P<0.05);术后6个月,患者椎体前缘高度和椎体后缘高度与术后3个月比较,差异无统计学意义(P>0.05)。结论钉棒系统内固定对胸腰段爆裂性骨折患者脊柱稳定性具有积极的影响,可有效改善胸腰功能,值得大力推广。

Objective To study the effect of screw-rod system internal fixation on spinal stability in patients with thoracolumbar burst fracture(TBF).Methods 54 patients with thoracolumbar burst fracture were treated with screw-rod system internal fixation.The Cobb angle,ratio of the anterior and posterior edge heights of the vertebral body,and height of the anterior and posterior edge of the vertebral body were compared before and after surgery.Results The patient’s Cobb angle was(27.88±11.22)°before surgery and(5.36±1.88)°after surgery.The Cobb angle after surgery was less than that before surgery,and the difference was statistically significant(P<0.05).Before surgery,the ratio of the posterior edge height of the vertebral body was(89.35±2.33)%,and the ratio of the anterior edge height of the vertebral body was(54.13±13.33)%.At 1,3,and 6 months after surgery,the ratio of the posterior edge height of the vertebral body were(90.64±3.66)%,(91.33±4.55)%,and(90.35±2.56)%,and the ratio of the anterior edge height of the vertebral body were(91.24±4.33)%,(92.22±2.34)%,and(92.66±2.35)%.At 1,3,and 6 months after surgery,the ratio of the posterior edge height of the vertebral body and ratio of the anterior edge height of the vertebral body of the patients were higher than those before surgery,and the difference was statistically significant(P<0.05).At 3 and 6 months after surgery,there was no statistically significant difference in the ratio of the posterior edge height of the vertebral body and the anterior edge height of the vertebral body compared with those 1 month after surgery(P>0.05).At 6 months after surgery,there were no statistically significant difference in the ratio of the posterior edge height of the vertebral body and the anterior edge height of the vertebral body compared with those 3 months after surgery(P>0.05).Before surgery,the height of the anterior edge of the vertebral body was(19.88±3.22)mm,and the height of the posterior edge of the vertebral body was(32.33±1.33)mm;at 3 and 6 months after surgery,the height of the anterior edge of the vertebral body were(34.89±2.34)and(34.97±2.35)mm,and the height of the posterior edge of the vertebral body were(35.22±0.84)and(34.90±0.86)mm.At 3 and 6 months after surgery,the height of the anterior edge of the vertebral body and the height of the posterior edge of the vertebral body were higher than those before surgery,and the difference was statistically significant(P<0.05).At 6 months after surgery,there was no statistically significant difference in the height of the anterior edge of the vertebral body and the height of the posterior edge of the vertebral body compared with those 3 months before surgery(P>0.05).Conclusion Screw-rod system internal fixation has a positive effect on spinal stability in patients with thoracolumbar burst fracture,and can effectively improve the thoracolumbar function,which is worthy of vigorous promotion.