后路开窗减压伤椎短节段固定治疗胸腰椎爆裂性骨折临床疗效观察

目的：探讨应用后路开窗减压、伤椎短节段固定法治疗胸腰椎爆裂性骨折的疗效，为临床治疗提供参考方案。方法：选取在本院接受治疗的胸腰椎爆裂性骨折患者30例，对所选患者使用后路开窗减压与在伤椎及正常椎体内植入椎弓根钉固定治疗，于术后严密观察患者的神经功能变化、后突角（ Cobb’ s角）并定期做好对椎体高度变化的记录。结果：对30例患者进行随访，随访时间为1-4年，患者的伤椎骨愈合时间在4个月左右，术后2周椎体高度为正常高度的（93．82＆#177;4．03）％与术前的（55．23＆#177;3．51）％比较，差异经统计学检验，有统计学意义（t＝4．304，P＜0．05），且经观察，术后6个月，其高度无丢失，Cobb’s角与术前比较，明显改善（t＝3．901，P＜0．05），Oswestry 评分明显减少、神经功能Frankel 分级有明显提高（t＝6．503，X2＝21．037，P＜0．05）。结论：应用后路开窗减压、伤椎短节段固定法治疗胸腰椎爆裂性骨折，其疗效安全有效，值得临床推广应用。

Clinical Efficacy of Posterior Window Decompression and Injured Vertebrae Short Segment Fixation in Treating Thoracolumbar Burst Fracture

Objective：To observe the efficacy of posterior window decompression and injured vertebrae short segment fixation in treating thoracolumbar burst fracture , to provid reference for clinical treatment . Method：30 patients with thoracolumbar burst fracture treated in our hospital were selected .All patients were treated with posterior window decompression and injured vertebrae short segment fixation .Neurological func-tion and posterior cornu of all patients was observed after operation .And vertebral height was recorded regu-larly.Result：30 patients were followed for 1 to 4 years.The healing time of injured vertebrae was about 4 months.The vertebral height was （93.82＆#177;4.03）%of normal height 2 weeks after operation, which was dif-ferent from （55.23＆#177;3.51）%before operation, which had statistical significance （t=4.304,P＆lt;0.05）.There was no loss of the height 6 months after operation , and Cobb ’ s angle had evident improvement compared with that before operation （t=3.901,P＆lt;0.05）.Oswestry score reduced evidently , and neurological function Frankel grade improved evidently （ t=6.503,X2=21.037,P＆lt;0.05） .Conclusion： Posterior window decom-pression and injured vertebrae short segment fixation in treating thoracolumbar burst fracture has safe and ef -fective efficacy , which is worthy of application and clinical promotion .