摘要
目的探讨腰椎爆裂性骨折患者采用脊柱前路内固定器系统固定与脊柱后路椎弓根钉棒系统内固定治疗的临床疗效差异。方法随机将2011年5月至2013年5月收治的90例腰椎爆裂性骨折患者分为前路组和后路组各45例。前路组采用前路内固定器系统内固定治疗,后路组采用椎弓根钉棒系统内固定治疗。比较两组患者的手术情况,Cobb角测定值及丢失情况,椎管狭窄程度恢复情况以及神经功能恢复情况。结果前路组的手术时间、术中出血量、术后出血引流量均显著的高于后路组(P<0.05)。治疗前、术后即刻两组患者的Cobb角测定值差异无显著性(P>0.05);术后1年前路组的Cobb角丢失度显著的低于后路组患者(P<0.05)。术后1周、1年两组患者的前后径、横断面积较治疗前均显著好转(P<0.05),术前、术后1周两组患者的前后径、横断面积差异无显著性(P>0.05),术后1年前路组的前后径、横断面积值显著的优于后路组(P<0.05)。治疗前、治疗后1年两组患者间的ASIA分布差异无显著性(P>0.05);治疗后两组患者的ASIA均优于治疗前(P<0.05)。结论较后路椎弓根钉棒系统内固定治疗腰椎爆裂性骨折,采用脊柱前路内固定器系统固定治疗的手术时间等术中情况复杂一些,但是术后Cobb角丢失度小,椎管狭窄程度小,因此应根据患者的情况酌情选择手术方法。
Objective To explore the difference in curative effect of anterior spinal internal fixation with rod system and posterior spinal pedicle screw fixation in treatment of patients with lumbar burst fractures. Methods According to the sequence of admission to the Department of Orthopedics in this hospital during May 2011 to May 2013,90 patients with lumbar burst fractures were divided into anterior group and posterior group,and 45 cases in each group. Patients in anterior group were treated with anterior internal fixation system,and patients in posterior group were treated by fixation with posterior pedicle screw rod system. The clinical curative effects of patients in these two groups were compared with surgical condition,figures of Cobb angle measurement and its loss in these cases,the condition of recovery of spinal canal stenosis and nerve function.Results The operating time,volume of intraoperative bleeding and drainage of postoperative hemorrhage in patients of anterior group were significantly higher than those in patients of posterior group（ P〈0. 05）. The figures of Cobb angle measurement before treatment and immediately after treatment in these 2 groups showed no significant difference（ P〉0. 05）. The figures of Cobb angle in 1 year after surgery were significantly lower than the degrees of angle loss in patients of posterior group（ P〈0. 05）. The diameter and cross- sectional area in patients of these 2 groups in 1year after treatment were significantly improved than those before treatment（ P〈0. 05）. The difference in size of transaction in patients of these2 groups before and 1 week after the operation was not significant（ P〉0. 05）,and the size and value of cross- sectional area in anterior group in one year after operation was improved than those of posterior group（ P〈0. 05）. The difference in distribution of ASIA in patients of these 2groups before treatment and 1 year after treatment was not significant（ P〉0. 05）. ASIA in patients of these 2 groups after treatment had been improved in comparison with that before treatment（ P〈0. 05）. Conclusion The condition of patients with lumbar burst fracture treated with spinal anterior internal fixation system is more complicated in some patients,but the loss of postoperative Cobb angle is small,and the degree of stenosis in spinal canal is small in comparison with that of fixation with posterior pedicle screw rod system,so it should be applied according to the situation of discretion to choose operation method.
出处
《临床和实验医学杂志》
2016年第1期19-23,共5页
Journal of Clinical and Experimental Medicine
基金
湖北省自然科学基金资助项目(编号:2012CDB07702)
关键词
腰椎爆裂性骨折
前路内固定器系统
后路椎弓根钉棒系统
内固定
Lumbar burst fracture
Anterior internal fixation system
Posterior pedicle screw rod system
Internal fixation
