椎弓根螺钉固定植骨联合椎管减压治疗无神经损伤的胸腰椎爆裂性骨折的临床研究

目的观察联合后路椎管减压与否，对柞弓根螺钉固定植骨治疗无神经损伤的胸腰椎爆裂性骨折疗效影响。方法对2009年1月～2011年9月本院43例无神经损伤的胸腰椎骨折患者，随机分两组．A组21例采用椎弓根螺钉同定植骨联合后路椎管减压治疗；B组22例采用椎弓根螺钉同定植骨治疗。观察两组手术前、术后1周、末次随访包括Cobb角改变、伤柞中央与正常椎高度比、随访疼痛Denis分级，Oswestry功能障碍指数（O-DI）等指标。并进行统计学分析。结果两组不同随访时间点ODI比较差异均无统计学意义（P〉0．05）；两组患者术后1年疼痛Denis分级比较差异无统计学意义（P〉0．05）；两组伤椎中央高度与正常比值及Cobb角的改变比较差异无统计学意义（p〉0．05）。结论联合后路柞管减压与否，对柞弓根螺钉同定植骨治疗无神损伤的胸腰椎爆裂性骨折近期疗效无明显差别。

Clinical study of pedicle screw fixation and grafting combining with the operation of decompression in treating thoracolumbar burst fractures without neurological deficit

Objective To observe therapeutic efficacy of pedicle screw fixation and grafting combining with the operation of decompression or not in treating thoracolumbar burst fractures without neurological deficit. Methods Fortythree patients diagnosed as thoracolumbar burst fractures without neurologic deficit were randomly divided into two group in our hospital from January 2009 to December 2011; Group A of 21 cases were treated with pedicle screw fixation and grafting combining with the operation of decompression; Group B of 22 cases were treated with pedicle screw fixation and grafting. Observed the two groups before surgery and postoperative 1 week, the final follow-up including Cobb Angle change, and wound job central and normal vertebral height ratio and follow-up pain Denis classification, oswestry dysfunction index （ODI）, and other indicators. And the statistical was analyzed. Results There was no significant difference between two groups in the Denis Grade of pain, ODI （P 〉 0.05）, Cobb＇s angle and the height ratio of the injuried vertebra to normal vertebra （P 〉 0.05）. Conclusion There is no difference in recent therapeutic efficacy, between two groups of thoracolumbar burst fractures without neurological deficit treated with pedicle screw fixation and grafting combining with the operation of decompression or not.