前后入路减压内固定治疗胸腰椎爆裂骨折合并脊髓损伤的疗效比较

目的：比较前、后入路减压内固定治疗胸腰椎爆裂骨折合并脊髓损伤的临床疗效。方法：以我院2012年1月～2014年7月收治的64例胸腰椎爆裂骨折合并脊髓损伤患者为研究对象，根据不同入路方式将其分为前入路组与后入路组，比较两组手术相关指标、手术前后后凸Cobb角、伤椎高度及Frankel分级情况。结果：两组手术时间、术中出血量及住院时间比较差异无统计学意义。前入路组植骨融合时间、随访12个月后凸Cobb角分别为（3.5±1.2）月、（4.7±2.0）°，均明显低于后入路组的（4.9±1.2）月、（7.1±2.3）°。两组随访12个月Frankel分级较术前明显改善，但两组间比较差异无统计学意义。结论：前入路、后入路减压内固定治疗胸腰椎爆裂合并脊髓损伤疗效均较好，前者植骨融合时间明显更短，后凸Cobb角丢失相对少，临床需根据适应证选择合适术式。

Comparison of the therapeutic effect of anterior and posterior approach decompression and internal fixation for thoracolumbar burst fracture with spinal cord injury

Objective To compare the clinical effect of anterior and posterior approach decompression and internal fixation for thoracolumbar burst fracture with spinal cord injury. Methods From Jan 2012 to 2014 July, 64 cases of thoracolumbar burst frac-ture combined with spinal cord injury patients as the research object, according to the different ways will be divided into the ante-rior approach group and into the road group, compared two groups of operation related index, pre-and post-operative Cobb angle, vertebral height and Frankel grade. Results There was no significant difference between the two groups. In the anterior approach group and bone graft fusion time and followed up for 12 months after Cobb angle respectively (3.5±1.2) months, (4.7±2.0) degrees, were significantly lower than in group of Road (4.9±1.2) month, (7.1±2.3) degree, the difference was statistically significant. The two groups were followed up for 12 months, compared with preoperative Frankel grading, but there was no significant difference be-tween the two groups. Conclusion Anterior approach, into the anterior decompression and internal fixation for thoracolumbar spinal burst with spinal cord injury and the effect was better in the former graft bone fusion time was significantly shorter, after Cobb angle loss is relatively small, clinical need according to the indications of the right choice of surgical procedure.