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Received:December 15, 2017 Published Online:June 21, 2018
Received:December 15, 2017 Published Online:June 21, 2018
中文摘要: 目的 探讨短节段内固定结合经椎弓根椎体内植骨治疗胸腰椎爆裂性骨折的疗效。方法 选择2014年6月至2016年6月收治的胸腰椎爆裂性骨折患者64例,按照数字随机表分为两组,每组32例。对照组采用单纯短节段内固定治疗,观察组采用短节段内固定结合经椎弓根体内植骨治疗。观察并记录两组围手术期指标和手术前、手术后6个月的疼痛评分、神经功能评分、伤椎前缘高度比、伤椎椎体楔形变角、脊柱Cobb角情况,并统计两组治疗优良率情况,进行对比分析。结果 观察组治疗优良率高于对照组,差异有统计学意义(96.88%vs 71.87%,P<0.05)。观察组手术时间和术前肌酸激酶指标与对照组相比,差异无统计学意义(P>0.05);观察组术后引流量、术后24 h肌酸激酶、带支具离床时间和住院时间均少于对照组,差异有统计学意义(P<0.01)。两组术后6个月的视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)均低于术前,且观察组术后6个月的VAS评分、ODI评分均低于对照组,差异均有统计学意义(P<0.05)。两组术后6个月伤椎前缘高度比均高于术前,伤椎椎体楔形变角和脊柱Cobb角均低于术前,差异均有统计学意义(P<0.05);且观察组术后6个月伤椎前缘高度比均高于对照组,伤椎椎体楔形变角和脊柱Cobb角均低于对照组,差异均有统计学意义(P<0.01)。结论 短节段内固定结合经椎弓根椎体内植骨治疗胸腰椎爆裂性骨折可显著提高临床疗效,减轻疼痛,改善神经功能,促进早日恢复。
Abstract:Objective To investigate the clinical effect of short-segment internal fixation combined with transpedicular bone graft in the treatment of thoracolumbar burst fractures. Methods A total of 64 patients with thoracolumbar burst fractures who were treated between June 2014 and June 2016 were selected and divided into control group and study group (32 cases each) according to the digital random table. The control group patients received single short-segment internal fixation, and the study group patients received short-segment internal fixation combined with transpedicular bone graft. The perioperative clinical indexes and visual analogue scale (VAS), Oswestry disability index (ODI), fracture vertebra height ratio (FVHR), vertebral wedge angle and Cobb angle before and 6 months after the operation were collected. The good rate of treatment in two groups was analyzed and compared. Results The good rate of treatment in study group was higher than that in control group (96. 88% vs 71. 87%, χ2=5. 807, P=0.016). There were no differences in operation time and preoperative creatine kinase (CK) level between two groups (all P>0.05). The postoperative drainage volume, CK level at 12 hours after the operation, bed off with support time and hospitalization time in study group were significant lower than those in control group (all P<0.01). The VAS and ODI score at 6 months after the operation were lower than those before the operation in both group, and they were lower in study group than control group (all P<0.05). The FVHR was higher and vertebral wedge angle and Cobb angle were lower at 6 months after the operation in both group. FVHR was higher and vertebral wedge angle and Cobb angle were lower in study group than those in control group at 6 months after the operation (all P<0.05). Conclusion Short-segment internal fixation combined with transpedicular bone graft in the treatment of thoracolumbar burst fractures has advantages of improving clinical efficacy, relieving pain, improving nerve function, and promoting recovery.
keywords: Short-segment internal fixation Transpedicular bone graft Thoracolumbar burst fractures Visual analogue scale Oswestry disability index
文章编号： 中图分类号：R 683.2 文献标志码：B
基金项目:徐州市科技计划项目(社会发展)(KC16SH095)
| Author Name | Affiliation |
| HOU Lei, GUO Kai-jin, WU Ji-bin | Department of Orthopedic, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China |
| Author Name | Affiliation |
| HOU Lei, GUO Kai-jin, WU Ji-bin | Department of Orthopedic, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, China |
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