前后路椎体次全切除重建减压内固定治疗胸腰椎爆裂性骨折的对比研究
发布时间：2019-01-28 08:52
【摘要】：目的：既往对于严重胸腰椎骨折伴脊髓损伤病例多采用前路手术治疗。但近年来部分学者采用单纯后路椎体次全切除减压重建内固定术治疗此类患者并取得一定疗效。何种手术治疗更加理想,目前仍存在争议。本研究通过比较分析前路和后路椎体次全切除重建减压内固定治疗胸腰椎爆裂性骨折的临床疗效。方法：回顾性分析2006年5月-2012年12月我科采用前路和后路椎体次全切除重建减压内固定治疗42例胸腰椎爆裂性骨折患者的资料,按手术方式分为前路手术组(A组)共23例,后路手术组(B组)共19例。至少随访24个月,比较两组患者临床结果和影像学结果。结果：两组患者均未发生内固定松动和断裂,均得到良好骨性融合。A组手术时间和术中出血量多于B组,差异具有统计学意义。B组肺功能明显优于A组。两组末次随访VAS评分、JOA评分及Frankel分级均较术前有明显改善,但组间差异无统计学意义(P0.05)。术前、术后一周及末次随访时两组间伤椎椎体前缘高度、后凸Cobb角比较差异均无统计学意义(P0.05)。结论：前路和后路椎体次全切除减压内固定均能有效治疗胸腰椎爆裂性骨折,但后路更有优势,术中出血量少、手术时间短,并发症少,对肺功能影响小,是更为安全的手术方式。
[Abstract]:Objective: to treat severe thoracolumbar fractures with spinal cord injury by anterior approach. However, in recent years, some scholars have used posterior subtotal vertebral body decompression and reconstruction internal fixation to treat this kind of patients and achieved certain curative effect. It is still controversial as to which surgical treatment is more ideal. This study analyzed the clinical effect of anterior and posterior subtotal vertebral body reconstruction decompression and internal fixation for thoracolumbar burst fracture. Methods: the data of 42 patients with thoracolumbar burst fracture treated by anterior and posterior subtotal vertebra resection and reconstruction internal fixation from May 2006 to December 2012 were retrospectively analyzed. 23 cases were divided into anterior approach group (group A) and anterior approach group (group A). There were 19 cases in the posterior approach group (group B). Follow up for at least 24 months and compare the clinical and imaging results between the two groups. Results: there was no internal fixation loosening and fracture in both groups, and good bone fusion was obtained in both groups. The operative time and blood loss in group A were more than those in group B. the pulmonary function in group B was significantly better than that in group A. The VAS score, JOA score and Frankel grade were significantly improved in the last follow-up of the two groups, but there was no significant difference between the two groups (P0.05). There was no significant difference in anterior height and kyphosis Cobb angle between the two groups (P0.05). Conclusion: anterior and posterior subtotal vertebral body decompression and internal fixation can effectively treat thoracolumbar burst fracture, but the posterior approach has more advantages, such as less intraoperative bleeding, shorter operative time, less complications and less influence on lung function. Is a safer procedure.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2416906
[Abstract]:Objective: to treat severe thoracolumbar fractures with spinal cord injury by anterior approach. However, in recent years, some scholars have used posterior subtotal vertebral body decompression and reconstruction internal fixation to treat this kind of patients and achieved certain curative effect. It is still controversial as to which surgical treatment is more ideal. This study analyzed the clinical effect of anterior and posterior subtotal vertebral body reconstruction decompression and internal fixation for thoracolumbar burst fracture. Methods: the data of 42 patients with thoracolumbar burst fracture treated by anterior and posterior subtotal vertebra resection and reconstruction internal fixation from May 2006 to December 2012 were retrospectively analyzed. 23 cases were divided into anterior approach group (group A) and anterior approach group (group A). There were 19 cases in the posterior approach group (group B). Follow up for at least 24 months and compare the clinical and imaging results between the two groups. Results: there was no internal fixation loosening and fracture in both groups, and good bone fusion was obtained in both groups. The operative time and blood loss in group A were more than those in group B. the pulmonary function in group B was significantly better than that in group A. The VAS score, JOA score and Frankel grade were significantly improved in the last follow-up of the two groups, but there was no significant difference between the two groups (P0.05). There was no significant difference in anterior height and kyphosis Cobb angle between the two groups (P0.05). Conclusion: anterior and posterior subtotal vertebral body decompression and internal fixation can effectively treat thoracolumbar burst fracture, but the posterior approach has more advantages, such as less intraoperative bleeding, shorter operative time, less complications and less influence on lung function. Is a safer procedure.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
【参考文献】
相关期刊论文 前1条
1 晏礼;宋文慧;王春强;;胸腰椎骨折分类及治疗研究新进展[J];中国矫形外科杂志;2013年12期
，本文编号：2416906
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