不同入路减压内固定治疗胸腰椎爆裂骨折

目的 探讨不同入路减压内固定治疗胸腰椎爆裂骨折的疗效.方法 将92例胸腰锥爆裂性骨折患者根据病情和患者知情同意分为两组：后路短节段椎弓根螺钉内固定融合术47例,前路减压钛网植骨内固定术45例.对两种治疗方式的疗效进行比较.结果 两组均获满1年随访.两组患者的神经功能均好转;两组患者治疗1年后较治疗前的椎体前缘高度、Cobb角均有明显改善（P〈0.05）;治疗后两组间椎体前缘高度、Cobb角比较差异无统计学意义（P〉0.05）;两组均无顽固性腰痛及内固定断裂等并发症发生.结论 后路短节段椎弓根螺钉内固定融合术和前路减压钛网植骨内固定术治疗胸腰椎爆裂骨折均可取得较好效果.

Different approach decompression and internal fixation in treatment of thoracolumbar burst fractures

Objective To investigate the different approach decompression and internal fixation in treatment of thora-columbar burst fracture. Methods The burst fractures in 92 cases, according to the illness and the patient informed consent were divided into two groups： posterior short segment pedicle screw fixation and fusion（47 cases） or anterior decompression and titanium mesh and bone graft and internal fixation （45 cases）. The efficacy of two treatment methods was compared. Results The two groups got nerve function improvement after 1 year of follow-up. Two groups got increasing of the anterior vertebral height, and decreasing of Cobb angle （P 〈 0.05 ）, but the two groups had no difference （P 〉 0.05 ）. There were no complications of intractable lumbago and breakage of the internal fixation. Conclusions Both posterior short segment pedicle screw fixation and fusion or anterior decompression and titanium mesh and bone graft and internal fixation are effective on thoracolumbar burst fracture.