伤椎置钉对胸腰椎爆裂性骨折患者骨折愈合及神经功能恢复的影响

目的 探讨伤椎置钉对胸腰椎爆裂性骨折患者骨折愈合及神经功能恢复的影响.方法 选取本院2015年1月至2016年5月收治的100例单节段胸腰椎爆裂性骨折患者进行研究,按随机数字表法将其分为观察组与对照组,均采用后路短节段椎弓根螺钉固定治疗,对照组患者伤椎不置钉,观察组伤椎置钉,比较两组患者术后Cobb's角及伤椎前缘高度改善情况、血清炎性因子及脊髓损伤标志因子表达水平.结果 在术后6个月及术后12个月时,观察组患者伤椎前缘高度均较对照组高,差异有统计学意义(P＜0.05).在术后6个月及术后12个月时,观察组患者Cobb's角均较对照组小,差异有统计学意义(P＜0.05).两组患者IL-6、IL-8、IL-1β、IL-10、MPO、TNF-α比较差异无统计学意义(P＞0.05).两组患者HSP70、S100β、pNF-H、GFAP、NSE比较差异无统计学意义(P＞0.05).结论 伤椎置钉可有效维持后路短节段椎弓根螺钉固定对胸腰椎爆裂性骨折的治疗效果,对神经功能无明显影响.

Influence of screw placement in injured vertebra on neurological function and fracture healing in thorecolumbar burst fracture

Objective To investigate the influence of screw placement in injured vertebra on neurological function and fracture healing in thorecolumbar burst fracture.Methods 100 patients with thorecolumbar burst fracture in our hospital from January 2015 to May 2016 were chosen as experimental subjects,and were divided into observation group and control group according to the random number table method.All patients were treated with posterior short segment pedicle screw fixation,and the observation group was treated with screw placement in injured vertebra on the basis.Cobb's angle,anterior vertebral height,inflammatory factors,and spinal cord injury marker between the two groups were compared after operation.Results At 6 months and 12 months after operation,anterior vertebral height of the observation group were higher than those of the control group,with statistically different differences (P＜0.05).At 6 months and 12 months after operation,Cobb's angle of the observation group were less than those of the control group,with statistically different differences (P＜0.05).There were no statistically different differences in the levels of IL-6,IL-8,IL-1β,IL-10,MPO,TNF-α between the two groups (P＞0.05).There were no statistically different differences in the levels of HSP70,S100β,pNF-H,GFAP,NSE between the two groups (P＞0.05).Conclusion Screw placement in injured vertebra could effectively maintain the treatment effect of posterior short segment pedicle screw fixation in patients with thorecolumbar burst fracture,and has fewer influence on neurological function.