摘要
目的探讨直接或间接复位对无神经症状型胸腰椎爆裂性骨折椎管重塑的影响。方法将52例无神经症状型胸腰椎爆裂性骨折患者按照手术方式不同分为直接复位组(n=26)和间接复位组(n=26)。比较两组患者椎体骨块占位率、椎体前缘高度降低百分比、Cobb角、椎管重塑矢状径的恢复比率及ODI评分。结果患者均获得随访,时间12~15个月。末次随访时,两组ODI评分均较术前明显降低(P<0.001),两组间比较差异无统计学意义(P>0.05);两组椎体骨块占位率、椎体前缘高度降低百分比及Cobb角均较术前明显改善(P<0.01),两组比较差异无统计学意义(P>0.05);椎管重塑矢状径的恢复比率间接复位组为15.7%±8.9%,直接复位组为11.8%±9.2%,两组间比较差异有统计学意义(P<0.01)。结论直接或间接复位治疗无神经症状型胸腰椎爆裂性骨折患者均可获得较好的临床疗效。间接复位手术操作步骤减少,创伤小,且后期椎管重塑较好,更具优势。
Objective To explore the effect of direct or indirect decompression on spinal canal remodeling of thoracolumbar burst fractures without neurologic deficit.Methods According to the decompression method,52 patients with thoracolumbar burst fractures without neurologic deficit manifests were randomly divided into indirect or direct decompression groups,with 26 patients in each group.Vertebral bone occupational ratio,percentage of anterior vertebral height decrease,Cobb angle,recovery rate of spinal canal remodeling sagittal diameter,and ODI score were compared.Results All patients got follow-up of 12~15 months.At the last follow-up,the ODI scores were decreased significantly than the preoperation(P<0.001),but no significant difference was found between both groups(P>0.05).Vertebral bone occupational ratio,Cobb angle and percentage of anterior vertebral height decrease postoperatively were improved significantly(P<0.01).No significant difference of all parameters was found in both groups(P>0.05).The recovery ratio of self spinal canal remodeling sagittal diameter in indirect decompression group was 15.7%±8.9%,and 11.8%±9.2%in direct decompression group,there was statistical difference between two groups(P<0.01).Conclusions Either direct or indirect decompression is optional method for thoracolumbar burst fractures without neurologic deficit.However,indirect decompression may be preferable with fewer operation procedure,less damage and better spinal canal remodeling.
作者
曾娘华
易伟宏
王尔天
杨大志
王敏
褚千琨
ZENG Niang-hua;YI Wei-hong;WANG Er-tian;YANG Da-zhi;WANG Min;CHU Qian-kun(Dept of Spinal Surgery, Huazhong University of Science and Technology Shenzhen Hospital,Nanshan Hospital,Shenzhen, Guangdong 518052,China)
出处
《临床骨科杂志》
2020年第1期12-15,共4页
Journal of Clinical Orthopaedics
基金
深圳市南山区科技计划项目(编号:南科研卫2014022)
关键词
直接复位
间接复位
椎管重塑
无神经症状型胸腰椎爆裂性骨折
direct decompression
indirect decompression
spinal canal remodeling
thoracolumbar burst fractures without neurologic deficit
