镇痛下三维整复支具外固定治疗胸腰椎骨折

目的:比较镇痛下三维整复支具外固定与手术复位内固定治疗新鲜胸腰椎骨折的疗效,探讨简单有效治疗胸腰椎骨折的方法。方法:回顾性分析2013年2月至2017年8月在南京中医药大学附属苏州医院骨科住院并符合纳入排除标准的胸腰椎骨折患者40例,根据治疗方法分为三维整复支具外固定组(治疗组)和常规脊柱钉棒内固定系统手术治疗组(对照组)。治疗组20例,男9例,女11例,年龄26~68(52.8±11.3)岁;对照组20例,男10例,女10例,年龄26~64(50.6±8.8)岁。观察并比较两组患者治疗前后椎体前缘压缩度、脊柱后凸角度及腰痛VAS评分的变化。结果:40例患者均获得随访,治疗组随访时间5~37(16.1±8.8)个月,对照组随访时间5~29(17.3±6.0)个月,差异无统计学意义(P0.05)。两组患者经治疗后椎体前缘压缩度、Cobb角矫正及腰痛VAS评分均优于治疗前(P0.05),但组间比较差异均无统计学意义(P0.05)。结论:两种方法总体疗效相近,但三维整复配合外固定支架治疗胸腰椎骨折具有操作简单、创伤小、无须二次手术取出内固定物等优势。

Treatment of thoracolumbar fractures with three-dimensional reduction method and external fixation devices under analgesia

Objective:To compare the clinical effects between open reduction internal fixation and three-dimensional reduction with external fixation under analgesia in treating fresh thoracolumbar fractures,and explore the simple and effective method for thoracolumbar fractures.Methods:The clinical data of 40 patients with thoracolumbar fractures who met the inclusion and exclusion criteria in the department of orthopaedics affiliated to Suzhou Hospital of Nanjing University of Chinese Medicine from February 2013 to August 2017 were retrospectively analyzed. According to therapeutic methods,the patients were devided into treatment group and control group,20 cases in each group. Treatment group was treated by three-dimensional reduction method and external fixation devices under analgesia,and control group was treated by open reduction and common spinal fixation system. In treatment group,there were 9 males and 11 females,aged from 26 to 68 years old with an average of (52.8±11.3) years;and in control group,there were 10 males and 10 females,aged from 26 to 64 years old with an average of(50.6±8.8)years. Anterior vertebral body compression(AVBC),Cobb angle and visual analogue scale(VAS) were measured and compared in two group.Results:All 40 patients finished follow-up. The follow-up time in treatment group was 5 to 37 months with average of (16.1±8.8) months,in control group was 5 to 29 months with an average of(17.3±6.0) months. There was no significant difference between two groups(P>0.05). AVBC,Cobb angle,VAS score were obviously improved in all patients after treatment(P<0.05),but there were no significant difference between two groups(P>0.05).Conclusion:Clinical effect of two methods was similar in treating thoracolumbar fractures,but three-dimensional reduction and external fixation devices under analgesia has advantage of easy operation,smaller trauma and no need secondary surgery for removed internal fixation.