不同后路术式治疗胸腰椎爆裂骨折的临床效果比较

目的：探讨不同后路术式治疗胸腰椎爆裂骨折的临床效果。方法：将我院骨科收治的96例胸腰椎爆裂骨折患者随机分为两组，分别使用经伤椎椎弓根六钉固定法（六钉组，65例）和跨伤椎短节段四钉固定法（四钉组，31例）进行复位固定，测量并比较术后6个月两组矢状面Cobb角、冠状面Cobb角和伤椎椎体前缘压缩比及术后并发症情况的差异。结果：两组患者术前矢状面和冠状面Cobb角、伤椎椎体前缘压缩比的差异无统计学意义（P〉0．05）。术后6个月，六钉组矢状面Cobb角、伤椎椎体前缘压缩比、术后并发症发生率均显著低于四钉组（P〈0．05），两组冠状面Cobb角均为0°。四钉组术后并发痘的发生率为22．6％，而六钉组术后并发症的发生率为4．6％，显著低于四钉组（P〈0．05）。结论：经伤椎椎弓根六钉固定法治疗胸腰椎爆裂骨折疗效优于跨伤椎短节段四钉固定法．且不良反应较少．具有较高的临床应用价值。

Comparison of Clinical Effect of Different Posterior Route Surgical Approach on the treatment of Thoracolumbar Burst Fracture

Objective： To investigate the clinical effect of different posterior route surgical approach on the treatment ofthoracolumbar burst fracture. Mothods： 96 patients with thoracolumbar burst fracture were randomly divided into six screw fixation through injury pedicle group （six screw group, 65 cases） and short segment of four screw fixation group （four screw group, 31 cases）. The sagittal Cobb angle, coronal Cobb angle and front edge of vertebral compression ratio, incidence of postoperation complication were measured and compared 6 months after surgery. Results： There was no significant difference of sagittal Cobb angle, coronal Cobb angle and front edge of vertebral compression ratio between the two groups before surgery （P〉0.05）. The sagittal Cobb angle, front edge of vertebral compression ratio, and incidence of postoperation complication in the six screw group was significantly lower than those in the four screw group 6 months after surgery （P〈0.05）. The coronal Cobb angle in the two groups were both 0- 6 months after surgery. The incidence rates of postoperative complication in four screw group and six screw group were respectively 22.6% and 4.6%, which was significantly lower in four screw group than that in six screw group （P〈0.05）. Conclusions：The clinical effect of six screw fixation through injury pedicle on on the treatment of thoracolumbar burst fracture was better than short segment of four screw fixation, which was appropriate for clinic use.