经伤椎与跨伤椎椎弓根螺钉复位固定治疗单节段胸腰椎骨折疗效比较.docVIP

经伤椎与跨伤椎椎弓根螺钉复位固定治疗单节段胸腰椎骨折疗效比较 　　[摘要] 目的 对比和探讨经伤椎与跨伤椎椎弓根螺钉复位固定治疗单节段胸腰椎骨折的临床疗效，为单节段胸腰椎骨折治疗提供借鉴和参考。 方法 回顾性分析2012年6月～2014年6月间我院收治的72例单节段胸腰椎骨折患者的病例资料和随访资料，其中36例行传统跨伤椎椎弓根螺钉复位固定治疗者作为对照组，36例行经伤椎椎弓根螺钉复位固定治疗者作为观察组。观察并比较两组患者经手术治疗前后及1年随访时的伤椎椎体前后缘高度比及Cobb’s角。分别运用功能独立性评估表（FIM）和疼痛视觉模拟评分法（VAS）评价两组患者经手术治疗后的功能恢复效果和疼痛改善情况。 结果 观察组和对照组患者的术后FIM功能评分（66.87±17.39）分和（62.06±14.77）分均显著高于术前的（31.26±7.31）分和（29.97±5.82）分（P0.05）。影像学检查结果显示，观察组和对照组经手术治疗后椎体前缘高度比、椎体后缘高度比、Cobb’s角均比术前显著改善（P均0.05）。1年随访时发现，观察组患者的椎体前缘高度比（92.69±4.53）%和椎体后缘高度比（96.28±2.51）%显著高于对照组的（87.27±3.97）%和（94.25±2.76）%，观察组的Cobb’s角（5.82±2.98）°显著低于对照组的（10.89±3.88）°，差异均具有统计学意义（P均0.05）。 结论 跨伤椎和经伤椎椎弓根螺钉复位固定治疗均能有效复位固定伤椎，矫正损伤脊柱后凸畸形，缓解复位固定后的疼痛症状，改善患者术后功能。相比于跨伤椎复位固定方式，经伤椎复位固定治疗后的远期疗效更优，值得临床推广。 　　[关键词] 经伤椎；椎弓根螺钉；复位固定；单节段；胸腰椎骨折 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2016）12-0058-04 　　Comparison of the efficacy of pedicle screw fixation through and cross the injured vertebra in treating single segment thoracolumbar fractures 　　LING Shiyong CHEN Jun 　　Department of Orthopedics， the Zhabei Branch of the Affiliated Changzheng Hospital of the Second Military Medical University， Shanghai 200070， China 　　[Abstract] Objective To compare and investigate the efficacy of pedicle screw fixation through and cross the injured vertebra in treating single segment thoracolumbar fractures， and provide reference for treatment of thoracolumbar fractures. Methods From June 2012 to June 2014， the clinical data of seventy-two patients with single segment thoracolumbar fractures were analyzed retrospectively. All of the patients were divided into two groups， including thirty-six cases who received cross the injured vertebra pedicle screw reduction and fixation as the control group， and thirty-six cases who received through the injured vertebra pedicle screw reduction and fixation as the observation group. The injured vertebra height， Cobb’s angle， FIM scores and VAS scores were observed and compared between the two groups. Results After surgical treatment