胸腰椎骨折垫枕练功结合仙灵骨葆内服疗效观察

目的：观察用背部垫枕练功结合口服中成药仙灵骨葆胶囊治疗胸腰单纯性骨折的临床疗效。方法：将32例胸腰单纯性骨折患者采用配对比较,非手术组绝对卧床背部垫枕练功结合灵仙骨葆内服治疗;手术组复位椎弓根螺钉固定加植骨术。观察两组患者治疗前、治疗后1月和1年时随访侧位x线片椎体高度、后凸畸形角,并计算椎体高度压缩率,记录JOA评分结果。结果：术后随访14~30个月,平均15个月。所有病人治疗后的椎体高度、后凸cobb角及JOA评分结果较治疗前均具有显著的改善（P〈0.01）,两组间治疗后1个月、1年随访影像学观察指标、JOA评分结果无显著性差异（P〉0.05）。椎体前壁高度和中间高度明显恢复,后凸畸形得到矫正。随访期间疗效满意,伤椎高度无明显丢失。结论：对于无神经症状,轻中度畸形的胸腰椎单节段骨折,在严格选择合适病例的前题下,采用中医传统卧床垫枕练功结合口服仙灵骨葆胶囊治疗,可以有效防止治疗后椎体再塌陷发生,取得良好的短中期疗效。

Clinical Observation of Functional Exercise with Back Pillow combining Xianlinggubao Capsules for Traumatic Thoracolumbar Spine Fractures

Objective： To observe the clinical effects of functional exercise with the back pillow combining oral administration of Chinese patent medicine of Xianlinggubao Capsules（XLGB） for single level traumatic thoracolumbar spine fractures.Methods： Thirty-two consecutive patients with single level traumatic thoracolumbar spine fractures were enrolled in this study and randomly divided into 2 groups： the non-surgery group was treated with the functional exercise with the back pillow combining oral administration of XLGB,while the surgery group was treated with pedicle screw systems for reduction and fixation and bone graft.The results were quantitatively evaluated before treatment,one month and one year after treatment respectively.According to the concept of estimated vertebral height loss and kyphotic angle of vertebral fractures by radiographs,JOA was recorded.Results： All patients were followed up for 14-30 months（averagely 15 months） and significantly better results were obtained in vertebral height,kyphotic abnormality and JOA score after treatment（P〈0.01）.There were no remarkable differences in radiograph observation and JOA scores between the 2 group one month and one year after the treatment（P〉0.05）.The anterior and middle vertebral height was restored and kyphotic abnormality was corrected.During the period of follow-up,no marked vetebral height loss occurred and the curative effects were satisfactory.Conclusion： For patients with single level traumatic thoracolumbar spine fractures exclusive of nervous symptoms,the therapy of functional exercise with back pillow combining oral administration of XLGB is an effective therapy,which can prevent vertebral re-collapse and ensure good curative effect in short or middle term.