前、后路手术治疗胸腰椎爆裂骨折的疗效比较

目的 比较前、后路手术治疗胸腰椎爆裂骨折的临床疗效.方法 对2008年1月～2012年8月收治的52例胸腰椎爆裂骨折患者临床资料进行回顾性分析,其中行前路手术者（前路组）24例,行后路手术者（后路组）28例.观察两组患者的手术时间、术中出血量、术后引流量、并发症发生情况及术后6个月植骨融合率.术后均随访0.5~2年,分别于术前、出院前及末次随访时进行影像学检查以评价患者脊柱后凸畸形角度（Cobb角）改善及丢失情况.结果 前路组手术时间、术中出血量、术后引流量均明显高于后路组,术后6个月植骨融合率明显高于后路组（P＜0.01）;两组并发症发生率比较差异无统计学意义（P＞0.05）;前路组末次随访Cobb角改善及矫正度丢失两个指标明显优于后路组（P＜0.01）.结论 与后路手术相比,前路手术创伤较大、失血量较多,但在维持矫正度、防止Cobb角丢失方面效果更优,采取何种入路应根据患者具体病情来合理选择.

Comparison of curative effect of anterior and posterior surgery in the treatment of thoracolumbar burst fractures

Objective To compare the clinical effect of anterior and posterior surgery in the treatment of thoracolumbar burst fractures.Methods Clinical data of 52 patients with thorament burst fractures,who were admitted to hospital from Jan,2008 to Aug, 2012, were analyzed retrospectively. Of all the patients, 24 cases underwent anterior surgery （anterior group）, 28 cases received posterior surgery （ posterior group）.Then, observe their operation time, in- traoperative blood loss, postoperative drainage fluid amount, complications,transplanted bone fusion rate month 6 after operation.All patients were followed up for 0.5-2 years.In addition, they were given image examination before operation, before discharging from hospital, and at the last follow-up visit respectively, so as to evaluate the improvement and loss of kyphosis deformity angle（Cobb）. Results The operation time, operative blood toss, postoperative drain age amount and bone fusion rate in month 6 after operation of the anterior group were higher than those of posterior group（ P 〈0.05）.There was no significant difference between the two groups in terms of complication rates（ P 〉 0.01）.The improvement and loss of Cobb at the last follow-up visit of the anterior group was better than that of the posterior group（ P 〈0.01）.Conclusion Comparing with the posterior group, anterior group has more blood loss and operation wound, while the former is superior to the latter in maintaining orthopedic degree and preventing Cobb loss. Reasonable choice should be made for patients according to detailed and specific condition of patients.