[1]沙福祥.不同术式治疗不稳定性胸腰椎骨折的比较研究[J].医学信息,2019,32(24):72-74.[doi:10.3969/j.issn.1006-1959.2019.24.023]
　SHA Fu-xiang.A Comparative Study of Different Surgical Procedures in the Treatment of Unstable Thoracolumbar Fracture[J].Medical Information,2019,32(24):72-74.[doi:10.3969/j.issn.1006-1959.2019.24.023]
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不同术式治疗不稳定性胸腰椎骨折的比较研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年24期
页码:
72-74
栏目:
论著
出版日期:
2019-12-15

文章信息/Info

Title:
A Comparative Study of Different Surgical Procedures in the Treatment of Unstable Thoracolumbar Fracture
文章编号:
1006-1959（2019）24-0072-03
作者:
沙福祥
（南通大学附属医院分院/南通市老年康复医院骨科，江苏 南通 226000）
Author(s):
SHA Fu-xiang
(Branch of Affiliated Hospital of Nantong University/Department of Orthopaedics,Nantong Geriatric Rehabilitation Hospital,Nantong 226000,Jiangsu,China)
关键词:
胸腰椎骨折; 不稳定; 前路; 后路; 伤椎置钉
Keywords:
Thoracolumbar fracture; Instability; Anterior approach; Posterior approach; Injured vertebrae nailing
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2019.24.023
文献标志码:
A
摘要:
目的 观察减压植骨融合固定术及经椎弓根椎体内植骨融合联合伤椎置钉术治疗不稳定性胸腰椎骨折合并脊髓损伤的临床疗效。方法 选取2015年4月~2018年4月我院收治的56例不稳定性胸腰椎骨折合并脊髓损伤的患者，随机分成对照组和观察组，每组28例。对照组行减压植骨融合固定术治疗，观察组行经椎弓根椎体内植骨融合联合伤椎置钉术治疗。术后随访1.5年（至2019年10月）。比较两组手术时间、术中出血量、椎体前缘高度丢失程度、Cobb角矫正和丢失情况、Oswestry功能障碍指数（ODI）、伤椎内占位情况、脊髓功能E级、植骨融合率及术后并发症。结果 观察组的术中出血量少于对照组 [（420±210.67） ml vs （830.23±260.52）ml]，手术时间短于对照组 [（155.71±43.50） min vs （195.08±45.42） min]，Cobb角矫正丢失大于对照组 [（5.42±1.38）°vs （2.32±1.25）°]，椎体前缘高度丢失程度大于对照组 [（4.58±0.52）% vs （2.14±0.47）%]，差异均有统计学意义（P＜0.05）。两组术前ODI指数、伤内椎占位、脊髓功能E级及植骨融合率情况分别比较，差异均无统计学意义（P＞0.05）；随访时两组ODI指数、伤内椎占位情况及植骨融合率比较，脊髓功能E级占比升高，差异有统计学意义（P＜0.05）；观察组并发症发生率低于对照组（3.57% vs 17.86%），差异有统计学意义（P＜0.05）。结论 经椎弓根椎体内植骨融合联合伤椎置钉治疗不稳定性胸腰椎爆裂性骨折并脊髓损伤，固定安全可靠，出血量少，增加前中柱的稳定性，促进骨性融合以及恢复伤椎体的高度，减少术后并发症，值得临床应用。
Abstract:
Objective To observe the clinical efficacy of decompressive bone graft fusion fixation and transpedicular pedicle bone graft fusion combined with vertebral nail placement in the treatment of unstable thoracolumbar fracture with spinal cord injury. Methods A total of 56 patients with unstable thoracolumbar fracture and spinal cord injuries treated in our hospital from April 2015 to April 2018 were randomly divided into the control group and the observation group, with 28 cases in each group. The control group underwent decompressive bone graft fusion and fixation, and the observation group underwent transpedicular bone graft fusion and vertebral nail placement. The postoperative follow-up was 1.5 years (until October 2019). Comparison of surgical time, intraoperative blood loss, loss of anterior vertebral height, Cobb angle correction and loss, Oswestry dysfunction index (ODI), intravertebral occupancy, spinal cord function E, and bone graft fusion and postoperative complications.Results The intraoperative blood loss in the observation group was less than the control group [(420.35±210.67) ml vs (830.23±260.52) ml], and the operation time was shorter than the control group [(155.71±43.05) min vs (195.08±45.42) min], Cobb angle angular correction loss was greater than the control group [(5.42 ± 1.38) ° vs (2.32±1.25)°], and the degree of loss of the anterior height of the vertebral body was greater than that of the control group [(4.58±0.52)% vs (2.14± 0.47)%],there was statistical significance (P<0.05). At follow-up, the ODI index, vertebral space occupancy and bone graft fusion rate of the two groups were lower than before surgery, and the proportion of E-grade spinal cord function was increased before surgery,the differences were statistically significant (P<0.05). The incidence of complications in the observation group was lower than that in the control group (3.57% vs 17.86%),the difference was statistically significant (P<0.05).Conclusion Transpedicular pedicle vertebral bone grafting combined with vertebral nailing for the treatment of unstable thoracolumbar burst fracture and spinal cord injury is safe and reliable, with less bleeding, increased stability of the anterior column, and promoted bone fusion and Restoring the height of the injured vertebral body and reducing postoperative complications are worth clinical application.

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更新日期/Last Update: 2019-12-15