胸腰椎爆裂骨折后路手术复位效果与手术时间的关系

目的：分析胸腰椎爆裂骨折后路手术间接复位的效果与手术时间的关系。方法：将35例符合研究标准的患者按受伤到手术时间的不同分为2组，受伤7d内手术的为早期手术组共20例，受伤7-14d手术的为晚期手术组共15例。以Cobb角和椎管占位比例作为间接复位效果评价标准。结果：2组患者术前Cobb角及椎管占位比例差异均无统计学意义（P〉0．05），但术后Cobb角及椎管占位比例早期组均低于晚期组，差异有统计学意义（P〈0．05）。结论：胸腰椎爆裂骨折后路手术间接复位的效果与手术时间的选择有密切关系，早期手术可使间接复位取得满意的效果。

Relationship between Effects of Posterior Operative Indirect Reduction and Time of Surgery in Burst Fractures of Thoracolumbar

Objective: To study the relationship between effect of posterior operative indirect reduction and time of surgery in burst fractures of thoracolumbar. Methods: The patients were divided into two groups according to the time elapsed between injury and operation. Cases operated within 7 days after the injury were taken as the early surgery group (n=20) and operated between 7 and 14 days were considered as the late surgery group (n=15). The efficacy of treatment was evaluated by measurements of restoration Cobb angle and reduction of canal compromise. Results: Although there were no significant differences between the two groups regarding the age (P > 0.05) or preoperative Cobb angle (21.4 degrees versus 20.9 degrees, P > 0.05),postoperative improvement in the early surgery group was significantly better than that in the late surgery group (P < 0.05). Preoperative measurements of canal narrowing did not show a statistical difference between early and late groups (44.8% versus 44.0%, P> 0.05). There was a significant difference in postoperative measurements of the canal narrowing (5.0% versus 35%, P < 0.001). Conclusion: The effects of posterior operative indirect reduction in burst fractures of thoracolumbar is closely related to surgery time. The duration between the injury and surgical intervention appears to be very important for the success of operation.