两种脊柱内固定器械治疗严重胸腰椎骨折脱位疗效比较

目的:比较通用脊柱椎弓根钉棒矫形固定系统(GOSS)与弧形自锁椎弓根钉系统(ALPF)治疗严重胸腰椎骨折脱位的疗效。方法:对我科收治的76例严重胸腰椎骨折脱位患者,采用随机的方法应用ALPF和GOSS进行治疗并随访,采用ASIA分级评价术后脊髓神经功能恢复情况,椎体前缘高度恢复率及后凸角矫正率;并对椎体前缘高度丢失率及后凸Cobb角丢失率进行随访。结果:2组的疗效术后和随访均有显著差异,但ASIA分级评定2组比较差异无统计学意义。结论:治疗严重胸腰椎骨折脱位,GOSS对恢复及维持伤椎椎体前缘高度及脊柱后凸Cobb角比ALPF良,是一种治疗严重胸腰椎骨折脱位良好内固定器械。

Comparison of Two Spinal Internal Fixtures in the Treatment of Serious Thoracolumbar Fracture and Dislocation

Objective：To compare the clinical outcome of GOSS and ALPF in the treatment of serious thoracolumbar fracture and dislocation. Methods：Seventy-six patients with serious thoracolumbar fracture and dislocation were randomly treated by GOSS and ALPF. The restoration of spinal nerves, the recovery rate of anterior edge height of vertebral body and the correction rate of posterior convex angle were evaluated by ASIA. The loss rate of anterior edge height of vertebral body and posterior convex Cobb angle were followed up. Result：There were significant differences between the two groups in clinical outcome and the following-up result. There was no statistical significance in ASIA.Conclusion：GOSS is better than ALPF in the restoration and maintenance of anterior edge height of vertebral body and posterior convex Cobb angle. It is a fine internal fixation in treating serious thoracolumbar fracture and dislocation.