| 不同椎弓根螺钉内固定方式治疗胸腰段骨折疗效分析 |
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投稿时间：2018-06-06 修订日期：2018-08-11
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 中文摘要:目的：探讨不同椎弓根螺钉内固定方式治疗胸腰段骨折的疗效。方法：选取本院创伤骨2013.1-2016.12间收治的胸腰椎单一椎体骨折患者，共55例，按内固定方式的不同分为三组，其中传统跨伤椎4钉固定20例，为对照组；伤椎双侧6钉固定22例，为双侧组；伤椎单侧5钉固定13例，为单侧组。比较三组患者围手术期指标:手术时间、手术出血量、住院费用;腰背部疼痛功能指标:视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）;影像学指标:术后即刻伤椎高度、Cobb角矫正率及末次随访伤椎高度、Cobb角丢失率。结果：三组患者在手术时间、手术出血量方面均无明显统计学差异（P>0.05）；在住院费用方面，对照组明显低于单侧组与双侧组（P<0.05），且单侧组低于双侧组（P<0.05）。在VAS评分、腰椎ODI评分方面，三组术后不同时间点较术前均有明显改善（P<0.05），三组之间比较无明显统计学差异（P>0.05）。三组术后即刻伤椎高度、Cobb角矫正率无明显统计学差异（P>0.05）；在末次随访时伤椎高度及Cobb角丢失率方面，单侧组和双侧组均优于对照组（P<0.05），但单侧组和双侧组比较无明显统计学差异（P>0.05）。结论：三种椎弓根螺钉内固定方式均适用于胸腰段骨折治疗，短期疗效相当；伤椎单侧固定与双侧固定在维持伤椎高度及防止后凸畸形发生上均优于传统跨伤椎固定；伤椎单侧固定与双侧固定临床效果相当，但单侧固定住院费用更低，值得临床推广。 |
| 【关键词】胸腰椎骨折 椎弓根螺钉 伤椎固定 单侧,双侧 |
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| The clinical effectiveness of different pedicle screw fixation for the treatment of thoracolumbar fractures |
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| ABSTRACT Objective To discuss the clinical effectiveness of thoracolumbar fractures treated with different pedicle screw fixation.Methods:A total of 55 cases of single thoracolumbar fractures were selected in the hospital between January 2013 and December 2016.According to the different fixation methods,they were divided into three groups,control group:traditional short-segment 4 pedicle fixation in 20 cases;bilateral group: intermediate bilateral pedicle screw fixation in 22 cases;unilateral group:intermediate unilateral pedicle screw fixation in 13 cases.The three groups were compared by operation time, intra operative blood loss, hospitalization cost, VAS and ODI scores,the correction of the fractured vertebrae height and kyphosis angle postoperatively and the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up and so on.Results: There was no significant difference in operation time, intra operative blood loss, VAS score, ODI score, the correction of the fractured vertebrae height and kyphosis angle postoperatively among the three groups(P>0.05). In terms of hospitalization cost,the control group was significantly lower than the unilateral group and the bilateral group (P<0.05), and the unilateral group was lower than the bilateral group (P<0.05) .However,for the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up,the unilateral and bilateral group were significantly better than the control group (P<0.05),but there was no statistical difference between the unilateral and bilateral group(P>0.05).Conclusion: All the three different pedicle screw fixation are suitable for the treatment of thoracolumbar fractures and the short-term clinical effects are consistent.Compared with traditional short-segment 4 pedicle screw fixation, intermediate bilateral or unilateral pedicle screw fixationSwere more effective in maintaining the height of the fractured vertebrae and preventing the occurrence of kyphosis.The intermediate unilateral pedicle screw fixation was comparable to that of bilateral fixation at clinical outcomes,but the unilateral fixed hospitalization cost was lower, which was worthy of clinical promotion. |
| KEY WORDS thoracolumbar fractures pedicle screw fractured vertebra fixation unilateral bilateral |
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