【摘要】：目的：既往對(duì)于嚴(yán)重胸腰椎骨折伴脊髓損傷病例多采用前路手術(shù)治療。但近年來(lái)部分學(xué)者采用單純后路椎體次全切除減壓重建內(nèi)固定術(shù)治療此類患者并取得一定療效。何種手術(shù)治療更加理想,目前仍存在爭(zhēng)議。本研究通過(guò)比較分析前路和后路椎體次全切除重建減壓內(nèi)固定治療胸腰椎爆裂性骨折的臨床療效。方法：回顧性分析2006年5月-2012年12月我科采用前路和后路椎體次全切除重建減壓內(nèi)固定治療42例胸腰椎爆裂性骨折患者的資料,按手術(shù)方式分為前路手術(shù)組(A組)共23例,后路手術(shù)組(B組)共19例。至少隨訪24個(gè)月,比較兩組患者臨床結(jié)果和影像學(xué)結(jié)果。結(jié)果：兩組患者均未發(fā)生內(nèi)固定松動(dòng)和斷裂,均得到良好骨性融合。A組手術(shù)時(shí)間和術(shù)中出血量多于B組,差異具有統(tǒng)計(jì)學(xué)意義。B組肺功能明顯優(yōu)于A組。兩組末次隨訪VAS評(píng)分、JOA評(píng)分及Frankel分級(jí)均較術(shù)前有明顯改善,但組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)前、術(shù)后一周及末次隨訪時(shí)兩組間傷椎椎體前緣高度、后凸Cobb角比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：前路和后路椎體次全切除減壓內(nèi)固定均能有效治療胸腰椎爆裂性骨折,但后路更有優(yōu)勢(shì),術(shù)中出血量少、手術(shù)時(shí)間短,并發(fā)癥少,對(duì)肺功能影響小,是更為安全的手術(shù)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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 晏禮;宋文慧;王春強(qiáng);;胸腰椎骨折分類及治療研究新進(jìn)展[J];中國(guó)矯形外科雜志;2013年12期

，

本文編號(hào)：2416906