目的 探讨采用横突上嵴椎弓根螺钉置入治疗胸椎骨折的临床效果。方法 对本院骨科2012-02至2014-12收治的73例胸椎骨折患者的诊治及随访资料进行分析,根据手术方法分为研究组(39例,采用横突上塉椎弓根螺钉置入治疗)和对照组(34例,采用传统植钉法置入治疗),对两组患者的手术情况及术后12个月的随访情况进行比较分析。结果 研究组的手术时间(189.5±27.9)min、术中出血量(420.4±61.5)ml均显著低于对照组(P＜0.05)。研究组在术后即刻、末次随访时的椎体前缘高度(36.1±1.5)mm、椎体后缘高度(36.2±1.5)mm均显著高于对照组(P＜0.05)。术后即刻研究组的Cobb角(4.1±0.7)°显著小于对照组的(6.2±0.8)°(P＜0.05),术后末次随访研究组的Cobb角丢失度为(2.3±0.5)°显著小于对照组的(3.9±0.8)°(P＜0.05)。研究组的术后并发症率为10.25%低于对照组的14.71%但两组差异无统计学意义。结论 采用横突上塉椎弓根螺钉置入治疗胸椎骨折较传统置钉法置入术能够显著缩短手术时间、减少术中出血,有利于术后患者的恢复且疗效可靠。
Abstract
Objective To study the clinical effect of transverse process on the crest of pedicle screw placement in the fracture of thoracic spine. Methods This study used the retrospective method. 73 patients with thoracic spine fracture atre admitted in the Department of Orthopedics from 2012 February to 2014 December. Their fracture treatment and follow-up data were analyzed, and according to the operation method were divided into the study group (39 cases, using the transverse process on the crest of pedicle screw implantation therapy) and control group (34 cases, using the traditional planting nail implantation therapy). The results of follow-up 12 months after operation in the two groups were comparatively analyzed. Results In study group, operative time (189.5±27.9) min, blood loss (420.4±61.5) ml were significantly lower than in control group (P＜0.05). In study group vertebral height immediately after surgery and last follow-up (36.1±1.5) mm, edge height of vertebral body (36.2±1.5) mm were significantly higher (P＜0.05). Cobb angle immediately after surgery in the study group (4.1±0.7)° was significantly less than in the control group (6.2±0.8)° Lost Cobb angle(P＜0.05). after termination of the follow-up in study group (2.3±0.5)° was significantly less than in the control group (3.9±0.8)°(P＜0.05). Postoperative complication rate in study group was 10.25%, lower than the 14.71% in the control group but the difference was not statistically significant. Conclusions Using the transverse process on the pedicle screw implantation in the treatment of thoracic vertebral fracture crest, compared with the traditional method of nail implantation, can significantly shorten operation time, reduce intraoperative hemorrhage, be conducive to postoperative patients recovery, and the curative effect is reliable.
关键词
横突上塉 /
椎弓根螺钉置入 /
胸椎骨折 /
传统置钉法
Key words
transverse process on crest /
pedicle screw fixation /
thoracic fracture /
traditional planting nail method
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