经伤椎置钉治疗胸腰椎骨折的临床运用及疗效分析

目的探讨运用经伤椎置钉治疗胸腰椎骨折的效果。方法2008年6月～2011年12月，50例胸腰椎骨折患者分别采用传统伤椎上下邻椎置钉（A组）及上下邻椎置钉加经伤椎置钉（B组）治疗，每组25例。以切口长度、手术时间、术中出血量、术前与术后伤椎椎体高度、术前与术后的侧位Cobb角、腰背部疼痛发生情况、内固定失败率等方面对比2组治疗效果。结果切口长度、手术时间、术中出血量2组差异无统计学意义（P〉0．05）。2组患者术前、术后1周、术后6个月在椎体高度及Cobb角方面差异无统计学意义（P〉0．05）；在术后12个月及内固定取出后上述2项评价指标差异有显著的统计学意义（P〈0．05）。结论经伤椎置钉治疗胸腰椎骨折术后椎体高度保持良好，腰背痛发生率低，切口长度、术中出血及手术时间无明显增加，是一种安全可靠、切实有效的治疗方法。

Posterior pedicle screw fixation at injured level for treatment of thoracolumbar spine fracture: analysis of clinical application and curative effect

Objective To investigate the curative effect of posterior pedicle screw fixation at the injured lewel for the treatment of thoracolumbar spine fractures. Methods From June 2008 to December 2011, a total of 50 patients with thoraeolumbar spine fractures were equally randomized to Group A （treated with classic pedicle screw fixation ） and Group B （treated with pedicle screw fixation at the injured level）based on fixation methods（n = 25 ）. The incision length, operation time, amount of bleeding in operation, preoperative and postoperative fractured vertebral body height, segmental lordosis （ Cobb＇ s angle） , visual analogue scale （VAS） score of lumbar pain and failure rate of internal fixation were assessed and compared clinically. Results There were no statistical significance in incision length, operation time and amount of bleeding（ P 〉 0.05 ）. Also, there were no statistical significance in fractured vertebral body height and Cobb＇ s angle at pre-operation, postoperative 1 week and postoperative 6 months （ P 〉 0.05 ）, But it had statistical significance at 12 months posetoperative （ P 〈 0.05 ）. Conclusion Posterior fixation at the injured level is an adequate and effective .procedure for thoracolumbar spine fractures.