經傷椎椎弓根螺釘復位內固定治療單節段胸腰椎骨折的臨床療效觀察

[摘要] 目的 探討經傷椎椎弓根螺釘復位內固定治療胸腰椎骨折的臨床療效。 方法 整群選取并回顧性分析2009年3月—2016年3月該院收治的49例單節段胸腰椎骨折手術患者的臨床資料，按照治療方式分成兩組，觀察組23例行經傷椎椎弓根螺釘復位內固定，而采取傳統跨傷椎短節段固定患者26例作為對照組。觀察兩組患者手術前后前后傷椎高度的恢復情況，隨訪觀察Cobb角丟失情況。 結果 手術前后觀察組和對照組前柱高度變化分別為（40.21±4.83）%和（19.82±3.65）%，Cobb角變化分別為（9.79±3.27）°和（5.02±2.12）°，觀察組明顯優于對照組，差異具有統計學意義（P<0.05）。術后3個月時觀察組和對照組Cobb角丟失分別為（1.62±0.42）°和（5.59±1.23）°，6個月時分別為（2.38±0.42）°和（7.65±1.83）°，差異具有統計學意義（P<0.05）。術后1年時觀察組Cobb角無繼續丟失，對照組丟失（8.46±2.08）°。 結論 應用傷椎椎弓根螺釘技術治療單節段胸腰椎骨折臨床效果更好，固定穩定性好，能夠保證患者早日下地活動，值得臨床推廣。

[關鍵詞] 胸腰椎骨折；傷椎固定；療效

[中圖分類號] R68 [文獻標識碼] A [文章編號] 1674-0742（2016）11（a）-0005-03

[Abstract] Objective To investigate the clinical effect of the injured vertebral pedicle screw reduction and internal fixation in treatment of single segment thoracolumbar fractures. Methods Group selection and retrospectively analysis the clinical data of 49 cases of patients with single segmental thoracolumbar fractures from March 2009 to March 2016， including 23 patients who received through injured vertebral pedicle screw reduction and internal fixation as the observation group， 26 patients who received the short segment fixation traditional across the injured vertebra as the control group. Observed the forward the vertebral height recovery degree of the injured vertebra of the two groups before and after surgery. Follow-up and observed the lost situation of the Cobb Angle. Results The anterior column height change respectively was （40.21±4.83） % and （19.82±3.65） %， Cobb Angle respectively was （9.79±3.27） ° and （5.02±2.12） °， the observation group was better than the control group， had statistically significant difference （P < 0.05）.The Cobb Angle lost of the observation group and control group 3 months after surgery respectively was （1.62±0.42）°and （5.59±1.23）°， 6 months after surgery respectively was（2.38±0.42）°and （7.65±1.83）°， the observation group was less than the control group， had statistically significant difference（P < 0.05）. The Cobb Angle of the observation group 1 years after surgery no continue to lose， the control group lost（8.46±2.08）°. Conclusion Application of pedicle screw technique in the treatment of single segment thoracolumbar fractures has better clinical results， can ensure the patient's early activities， it is worth clinical promotion.

[Key words] Thoracolumbar fractures； Injured vertebral fixation；The curative effect

胸腰椎骨折是指由于外力造成胸腰椎骨質連續性的破壞，是最常見的脊柱損傷。臨床治療單節段胸腰椎骨折的手術多由后路經傷椎上下椎體椎弓根釘棒系統給予撐開復位內固定[1-3]。有學者嘗試行經傷椎椎弓根螺釘復位內固定治療單節段胸腰椎骨折，但其必要性及適應癥等問題尚存在一定爭議[4]。因此，回顧性分析2009年3月—2016年3月該院收治的49例單節段胸腰椎骨折手術患者的臨床資料，報道如下。

1 資料與方法

1.1 一般資料