减压AF系统内固定治疗胸腰椎爆裂性骨折伴脊髓损伤的疗效

目的:探讨减压AF系统内固定治疗胸腰椎爆裂性骨折伴脊髓损伤的疗效。方法:本研究选取了82例胸腰椎爆裂性骨折伴脊髓损伤的患者,年龄20-67岁,采用减压AF系统内固定方式治疗,对患者术前及术后6个月,12个月的伤椎椎体高度比,Cobb's角,Frankel标准分级,VAS评分,Oswestry功能障碍指数等指标进行检测,以评价减压AF系统内固定的疗效。结果:与术前相比,患者术后6个月,12个月的伤椎体高度比值明显升高,Cobb角值明显下降(P0.05)。术后6个月与12个月伤椎椎体高度比值和Cobb角值改善情况相比,差异没有统计学意义(P0.05)。神经功能恢复方面,16例恢复到了E级,术后A级有4例未恢复,Frankel分级为A的患者术后有效恢复率为90.2%;B级有2例未恢复,B级术后有效恢复率89.5%。C级和D级术后有效恢复率均为100%。患者术后6个月,12个月的VAS和ODI值均低于术前分值(P0.05),且术后12个月ODI值与术后6个月的相比,有显著性差异(P0.05)。结论:减压AF系统内固定法对胸腰椎爆裂性骨折及脊髓神经损伤情况具较好的治疗效果,患者术后痛觉感受明显降低,下腰功能恢复良好,治疗效果满意。

Efficacy of Decompression and Internal Fixation with AF SysteminTreatment of Thoracolumbar Burst Fracture with Spinal Injury

Objective:To discuss the efficacy of decompression and internal fixation with AF system to treat thoracolumbar burstfracture with spinal injury.Methods:82 patients with thoracolumbar burst fracture and spinal injury were selected, 20-67 years old, andthey were given decompression and internal fixation with AF system. Vertebral height ratio, Cobb''s angle, Frankel classfication, VAS andODI scores were tested before surgery and 6 months, 12 months after surgery. These indexes were adopted to evaluate the efficacy ofdecompression and internal fixation with AF system.Results:Compared with the value before surgery, the value of vertebral height ratio,Cobb''s angle was decreased apparently (P<0.05). There were no statistical significance between the values in 6 months and 12 monthsafter surgery (P>0.05). 16 cases recovered to Grade E in the nerve function aspect, and 4 cases of Grade A didn''t get better after surgery,so the postoperative effective recovery rate of Grade A patients was 90.2 %. 2 cases of Grade B didn''t recover after surgery, and thepostoperative effective recovery rate of Grade B patients was 89.5 %. Besides, the postoperative effective recovery rate of Grade C and Dwas 100 %. Compared with the value before surgery, the scores of VAS and ODI was decreased apparently (P<0.05). There wasstatistical significance between the ODI scores in 6 months and 12 months after surgery (P<0.05).Conclusion:Decompression andinternal fixation with AF system can obviously reduce the pain feeling and efficiently recover the lumbar function, indicating a goodtherapeutic efficacy to thoracolumbar burst fracture with spinal injury.