后路减压植骨融合椎弓根内固定治疗胸腰椎爆裂骨折疗效评价.docVIP

后路减压植骨融合椎弓根内固定治疗胸腰椎爆裂骨折疗效评价 　　[摘要] 目的 对后路减压植骨融合椎弓根内固定治疗胸腰椎爆裂骨折的疗效予以评价,并与前路手术进行比较。方法 130例胸腰椎爆裂骨折病中行前路手术65例,其余65例行后路手术,对后路手术与前路手术的手术效果进行比较。结果 后路手术与前路手术在手术时间、出血量方面比较,差异有统计学意义(P0.05)。后路手术比前路手术时间短、出血量少。后路手术组术后1年脊柱植骨融合率优于前路手术组(P0.05)。前路手术和后路手术术前椎体前、后缘高度有差异(P0.05),前路手术组较后路组压缩程度重。术后随访,椎体前缘丢失率前路、后路统计学有显著差异(P0.01),椎体后缘丢失率前路、后路比较,差异也有统计学意义(P0.01)。Cobb角由术前恢复到术后,前路、后路手术统计学均有显著性差异(P0.05)。术后随访,前路无明显丢失,后路丢失明显,差异有显著性(P0.01)。结论 后路手术同前路手术相比,出血少、手术操作简单,效果一样,但后纵韧带要完整。 　　[关键词] 后路减压; 植骨融合; 胸腰椎爆裂骨折; 疗效评价 　　[中图分类号] R683.2 [文献标识码] A [文章编号] 1673-9701(2010)15-03-03 　　 　　Posterior Decompression and Fusion Pedicle Screw Fixation for Thoracolumbar Burst Fracture 　　WANG Jianjin 　　Yibin County People’s Hospital,Yibin 644000,China 　　 　　[Abstract] ObjectiveTo evaluate right posterior decompression and fusion pedicle screw fixation for the treatment of thoracolumbar burst fractures and compare the method with the anterior approach surgery. MethodsIn 130 cases of thoracolumbar burst fracture treated in our hospital from Jan 2003 to Jan 2010,65 cases underwent anterior approach surgery and 65 cases,posterior approach surgery. The effect comparison was made between anterior approach surgery and posterior approach surgery. ResultsThere were significant differences in the surgery time and blood loss between anterior surgery and posterior surgery(P0.05),posterior approach surgery showing shorter time and less bleeding than the anterior approach surgery. The posterior approach surgery showed a higher bone graft fusion rate 1 year after spinal surgery compared with the anterior approach surgery(P0.05). There was a significant difference in the preoperative vertebral anterior border height and posterior border height between anterior surgery and posterior surgery(P0.05),the anterior approach surgery showing more severe compression than the posterior approach surgery. There was a significant difference in the loss rates of both postoperative vertebral anterior border and posterior border between anter