跨伤椎固定和经伤椎固定治疗胸腰椎骨折对椎体高度和侧弯角度改善效果比较.doc

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1、跨伤椎固定和经伤椎固定治疗胸腰椎骨折对椎体高度和侧弯角度改善效果比较［摘要］目的探讨跨伤椎固定与经伤椎固定治疗胸腰椎骨折对椎体高度及侧弯角度改善的效果。方法选择本院2010年1月〜2012年12月收治的63例胸腰椎骨折患者，按治疗方法分为两组，33例采用椎弓根螺钉跨伤椎固定治疗为A组，30例采用经伤椎固定治疗为B组，观察两组术前、术后、随访1年时的Cobb角、椎体前缘高度，随访观察两组患者的植骨融合率、脊髓神经恢复及局部疼痛情况。结果患者术后随访均满1年，平均14.5个月。术后5d,两组Cobb角、椎体前缘高度比

2、较，差异无统计学意义。随访1年时，两组椎体前缘高度比较差异无统计学意义；两组Cobb角比较，差异有统计学意义；内固定取出后A组Cobb角矫正度丢失更明显。随访显示，A组植骨融合率明显低于B组，差异有统计学意义。术后1年时两组脊髓神经功能恢复差异无统计学意义，但B组局部疼痛方面优于A组。结论经伤椎固定治疗胸腰椎骨折在植骨融合、脊柱矫正度维持及局部疼痛方面较跨伤椎固定有明显优势，值得应用。［关键词］胸腰椎骨折；固定；椎体前缘髙度；Cobb角［中图分类号］R683.2［文献标识码］A［文章编号］1674-4721(20

3、13)11(c)—0049—03Effectcomparisonofconsecutivepediclescrewfixationandshort-segmentpediclescrewfixationinvertebralbodyheightandscoliosisangleimprovementofthoracolumbarfractureHUANGJin-pingWANGJinHEFu-pingPeople7sHospitalofJinxiCountyinJiangxiProvince,Jinxi34480

4、0,China[Abstract]ObjectiveToinvestigatetheeffectofconsecutivepediclescrewfixationandshort—segmentpediclescrewfixationintebralbodyheightandscoliosisangleimprovementofthoracolumbarfracture・Methods63patientswiththoracolumbarfracturesinourhospitalfromJanuary2010t

5、oDecember2012wereselectedanddividedintotwogroupsaccordingtothetreatmentmethods,33casestreatedwithconsecutivepediclescrewfixationwereselectedasgroupA,30casestreatedwithshort-segmentpediclescrewfixationwereselectedasgroupB，thepreoperative，postoperative，andCobba

6、ngle1-yearfollowed-upandvertebralheightwereobserved,thebonegraftfusionrate,spinalnerverecoveryandlocalpainoftwogroupswereobserved・ResuItsPatientswerefollowedupforatleast1year,withanaverageof14.5months・Fivedaysaftersurgery,Cobbangleandvertebralheightoftwogroup

7、scompared,thedifferencewasnotstatisticallysignificant.After1-yearfollowed—up，vertebralheightoftwogroupswasnotsignificantlydifferent(P>0.05),Cobbangleoftwogroupswassignificantlydifferent,CobbangleofgroupAhadmorepronouncedlossofcorrection.Thefoilow-upshowedfusi

8、onrateofgroupAwassignificantlylowerthanthatofgroupB,thedifferencewasstatisticallysignificant・Thespinalcordnervefunctionrecoveryoftwogroupswasnosignificantlydifferent，butlocalpainofgroupBw