经伤椎单节段固定和跨伤椎短节段固定治疗胸腰椎骨折的临床效果对比

Comparison of Clinical Effects between Single Segment Fixation of Injured Vertebra and Short Segment Fixation of Trans Injured Vertebra in the Treatment of Thoracolumbar Fractures

目的:分析经伤椎单节段固定术与跨伤椎短节段固定术治疗胸腰椎骨折的效果。方法:纳入2018年10月-2019年8月诊治于泉州市正骨医院胸腰椎骨折患者90例,按随机数字表法分两组,各45例,对照组用跨伤椎短节段固定术,予以观察组经伤椎单节段固定术治疗。以两组手术情况、伤椎椎前缘高度比、Cobb角改善情况、术后并发症、生活质量、神经功能为观察指标。结果:观察组总出血量为(312.84±41.76)mL,手术切口长度为(6.48±1.19)cm,优于对照组的(454.57±56.08)mL与(9.25±1.15)cm;观察组伤椎前缘高度比(82.12±10.41)%,高于对照组的(76.29±10.96)%,伤椎Cobb角(10.81±6.42)°,低于对照组的(14.81±6.78)°,差异均有统计学意义(P<0.05);观察组、对照组术后12个月的神经功能Frankel分级改善评分分别为(0.53±0.15)、(0.48±0.17)分,差异无统计学意义(P>0.05);观察组并发症总发生率为2.22%,低于对照组的15.56%(P<0.05);观察组末次随访的生活质量评分高于对照组(P<0.05)。结论:经伤椎单节段固定术治疗胸腰椎骨折患者效果确切。

Objective:To analyze the effect of single segment fixation of injured vertebra and short segment fixation of trans injured vertebra in the treatment of thoracolumbar fractures.Method:A total of 90 patients with thoracolumbar fracture diagnosed and treated in Quanzhou Orthopedic Hospital from October 2018 to August 2019 were included.They were divided into two groups according to the random number table,45 patients in each group.The control group was treated with short segment fixation of injured vertebra,and the observation group was treated with segment fixation of trans injured vertebra.The operative condition,the ratio of the anterior edge height of the injured vertebra,the improvement of Cobb angle,postoperative complications,quality of life,and neurological function were observed in the two groups.Result:The total bleeding volume of the observation group was(312.84±41.76)mL,and the length of the surgical incision was(6.48±1.19)cm,which were better than(454.57±56.08)mL and(9.25±1.15)cm of the control group;in the observation group,the anterior edge height ratio of injured vertebra was(82.12±10.41)%,which was higher than(76.29±10.96)%of the control group,and the Cobb angle of injured vertebra was(10.81±6.42)°,which was lower than(14.81±6.78)°of the control group,the differences were all statistically significant(P<0.05).The Frankel grading improvement scores of the observation group and the control group were(0.53±0.15)points and(0.48±0.17)points respectively 12 months after operation,the difference was not significant(P>0.05).The total incidence of complications in the observation group was 2.22%,which was lower than 15.56%in the control group(P<0.05).The quality of life scores of the observation group at the last follow-up were higher than those of the control group(P<0.05).Conclusion:Single segment fixation of injured vertebra is effective in the treatment of thoracolumbar fracture.