经皮椎体成形术与切开复位内固定术治疗胸腰段压缩骨折的疗效探讨

目的比较经皮椎体成形术和切开复位椎弓根钉内固定治疗胸腰段椎体压缩性骨折的临床疗效。方法回顾性分析该院2009年1月—2012年7月间收治的椎体压缩性骨折患者120例,随机分为治疗组和对照组,每组60例,骨折节段均为T12-L2。观察组采用经皮椎体成形术治疗,对照组采用腰椎后路切开复位椎弓根钉内固定术,术后常规对症治疗,并随访2年,观察并比较两组手术并发症发生情况、椎体前缘高度、Cobb角和相邻椎间盘退变情况,并采用统计学软件进行分析。结果观察组无一例发生术后并发症,对照组2例出现脑脊液漏,对症治疗后缓解。末次随访发现观察组椎间盘退变指数（75.26±2.41）,低于对照组（88.25±2.57）,其差异有统计学意义（P〈0.05）。而两组椎体前缘高度和Cobb角差异无统计意义（P〉0.05）。结论胸腰段压缩性骨折患者行经皮椎体成形术后并发症发生率低,脊柱退变程度小,是一种有效的治疗手段。

Observation on the Comparison of Efficacy Between Percutaneous Vertebro-plasty and Open Reduction and Internal Fixation for Thoracolumbar Com-pression Fracture

Objective To compare the clinical efficacy between percutaneous vertebroplasty and open reduction and internal fixation in the treatment of thoracolumbar compression fracture. Methods 120 cases with vertebral compression fractures admitted in our hospital from January 2009 to July 2012 were randomly divided into the treatment group and the control group, each group of60 cases, fracture segments were T12-L2. The observation group was treated with percutaneous vertebroplasty, and the control group was treated with lumbar posterior open reduction and pedicle screw internal fixation. The patients were given routine symptomatic treatment postoperatively, and followed up for 2 years. The incidence of complications, anterior vertebral height, Cobb angle and the adjacent intervertebral disc degeneration of the two groups were observed and compared, and analyzed by statistical software. Results There was no one with postoperative complications in the observation group, while 2 cases with cerebrospinal fluid leakage in the control group but relieved after symptomatic treatment. It was found by the last follow-up that the index of intervertebral disc degeneration of the observation group was（75.26±2.41）, lower than（88.25±2.57） of the control group, the difference was statistically significant（P〈0.05）. There were no statistically significant differences in anterior vertebral height and Cobb angle between the two groups（P〉0.05）. Conclusion For patients with thoracolumbar compression fractures, the incidence of postoperative complications of percutaneous vertebroplasty is lower, the degree of spinal degeneration is smaller, which is an effective means of treatment.