摘要
目的探讨经伤椎单侧椎弓根减压后路复位固定及植骨治疗胸腰椎爆裂性骨折的效果。方法回顾性分析2010年1月~2015年2月重庆市石柱县中医院收治的82例胸腰椎爆裂性骨折患者的临床资料,根据手术方式将患者分为对照组（37例）及观察组（45例）。观察组给予经伤椎单侧椎弓根减压后路复位固定及植骨治疗,对照组给予经伤椎单侧椎弓根减压后路复位固定治疗。观察患者的手术时间及术中出血量;术前及术后3个月,采用Franke1分级对患者神经功能进行评价;观察两组患者术前、术后1周、术后3个月的Cobb角及伤椎前缘高度;观察术后3个月及术后1年观察组患者脊柱植骨融合情况。结果两组患者的手术时间及术中出血量比较,差异无统计学意义（P〉0.05）。观察组患者术后3个月、1年脊柱植骨融合率分别为71.11%（32例）、20%（9例）。所有患者均顺利完成手术,平均随访（10.67±1.29）个月。术前两组患者Cobb角及伤椎前缘高度比较,差异均无统计学意义（P〉0.05）;术后1周、术后3个月两组患者Cobb角明显低于术前,伤椎前缘高度明显高于术前,且术后1周、术后3个月观察组Cobb角均低于对照组,差异均有统计学意义（P〈0.05）;两组患者术后1周Cobb角及伤椎前缘高度与术后3个月比较,差异均无统计学意义（P〉0.05）。结论经伤椎单侧椎弓根减压后路复位固定及植骨术可有效治疗胸腰椎爆裂性骨折患者,操作简单,且不增加手术时间及术中出血量,值得临床应用。
Objective To explore the effect of decompression of unipedicular, restoration through posterior and bone grafting in the treatment of thoracolumbar burst fracture. Methods From January 2010 to February 2015, in Hospital of Traditional Chinese Medicine of Shizhu County, the clinical data of 82 patients with thoracolumbar burst fracture were retrospectively analyzed, and they were divided into control group（n = 37） and the observation group（n = 45） according to the operation methods, patients of the observation group was given the treatment of decompression of unipedicular, restoration through posterior and bone grafting; control group was given the treatment of decompression of unipedicularr, restoration through posterior. Operative time and intraoperative blood loss of patients were observed; before and 3months after operation, nerve function of patients was evaluated by Franke1 classification; Cobb angle and height of taper leading edge of patients in two groups before and 1 week, 3 months after operation and the spinal bone graft fusion of patients in the observation group 3 months and 1 year after operation were observed. Results Operative time and intraoperative blood loss between two groups had no statistically significant differences（P 0.05）. 3 months, 1 year after operation, rate of spinal bone graft fusion in the observation group were 71.11%（32 cases） and 20%（9 cases） respectively. Surgery of all patients were successful, mean follow-up time was（10.67 ±1.29） months. Cobb angle and taper leading edge height in the two groups had no statistically significant difference（P 0.05）; 1 week and 3 months after operation, Cobb angle of two groups was significantly lower than before operation, height of tapered leading edge was significantly higher than before operation, 1 week and 3 months after operation, Cobb angle of the observation group were lower than those of the control group, the differences were statistical significance（P 0.05）; compared with 3months after operation, Cobb angle and height of tapered leading edge 1 week after operation had no statistically significant difference（P 0.05）. Conclusion Decompression of unipedicular, restoration through posterior and bone grafting in the treatment of thoracolumbar burst fracture can effectively treat the thoracolumbar burst fracture, simplicity of operator, and not increase the operative time and intraoperative blood loss, worthy of clinical application.
出处
《中国医药导报》
CAS
2016年第15期104-107,共4页
China Medical Herald
关键词
胸腰椎爆裂性骨折
椎弓根
减压
植骨
Thoracolumbar burst fracture
Pedicle
Decompression
Bone graft
