快速体位复位联合内固定治疗胸腰椎压缩性骨折疗效观察

Curative effect observation of rapid postural reduction combined with internal fixation in the treatment of thoracolumbar compression fracture

目的:通过观察快速体位复位联合内固定治疗胸腰椎压缩性骨折,为治疗胸腰椎压缩性骨折患者提供新思路。方法:选取符合纳入标准的胸腰椎压缩性骨折患者,在术前行快速体位复位,联合术中内固定治疗胸腰椎压缩性骨折。观察患者术前术后椎体前缘压缩率,疼痛感评分(VAS评分),JOA评分,症状、体征计分,术后并发症,术中出血,手术时间等各项临床指标。结果:手术时间47~102 min,平均56 min;术中出血153~390 m L,平均187 m L;术后随访12~22个月,平均16个月。末次随访椎体前缘压缩率由术前(0.423±0.145)减少至(0.104±0.031),VAS评分由术前(6.32±1.47)减少至(0.23±0.11),JOA评分由术前(14.21±1.82)增加至(27.93±0.96),症状、体征计分由术前(16.73±1.31)减少至(2.13±0.29)。结论:快速体位复位联合内固定治疗胸腰椎压缩性骨折,能够理想恢复并维持椎体高度,临床并发症少,患者疼痛明显减轻,是治疗胸腰椎压缩性骨折的新思路。

Objective:By observing rapid postural reduction combined with internal fixation in the treatment of thoracolumbar compression fracture,to provide new ideas for the treatment of the patients with thoracolumbar compression fracture.Methods:The patients with thoracolumbar compression fracture in accordance with the inclusion criteria were selected.Before operation,the patients were given rapid postural reduction,and combined with internal fixation during operation in the treatment of thoracolumbar compression fracture.The fanterior edge compression rates, pain scores(VAS score),JOA scores,symptoms,signs scores and postoperative complications,intraoperative bleeding,operation time and other clinical indicators of patients were observed before and after the operation.Results:The operation time was 47~102 minutes,the average was 56 minutes,the intranperative bleeding was 153~390 m L,the average was 187 m L.Patients were followed up for 12~22 months after operation,the average was 16 months.In the last follow-up,the fanterior edge compression rate by preoperative(0.423±0.145) reduced to(0.104±0.031),preoperative VAS score(6.32±1.47) reduced to(0.23±0.11),preoperative JOA score(14.21±1.82) increased to(27.93±0.96),preoperative symptoms,signs scores(16.73±1.31) reduced to(2.13±0.29).Conclusion:Rapid postural reduction combined with internal fixation in the treatment of thoracolumbar compression fracture can ideal restore and maintain vertebral height,its clinical complications are less,the pain of patients is significantly reduced.It is a new way to treat thoracolumbar compression fracture.