后路椎弓根钉内固定治疗多节段胸腰椎骨折临床观察.docVIP

后路椎弓根钉内固定治疗多节段胸腰椎骨折临床观察 　　摘要：目的 探讨后路弓根钉内固定治疗多节段胸腰椎骨折的临床效果。方法 从我院收治的多节段胸腰椎骨折患者中抽选84例作为临床研究对象，随机分为对照组（采用后路短节段椎弓根钉内固定治疗）和观察组（采用后路长节段椎弓根钉内固定治疗）各42例。比较两组患者的治疗效果。结果 观察组患者术中出血明显高于对照组，手术时间明显长于对照组，末次随访时的伤椎前缘高度比、矢状面Cobb 角明显优于对照组，结果对比差异显著（P0.05）。结论 后路长、短节段椎弓根钉内固定均能有效治疗多节段胸腰椎骨折，二者各具优缺点，但相对而言，长节段固定术的远期疗效更佳。 　　关键词：后路椎弓根钉内固定；多节段胸腰椎骨折；VAS评分；Oswestry功能障碍指数 　　中图分类号：R687 文献标识码：A 文章编号：1006-1959（2017）25-0055-02 　　Abstract：Objective To investigate the clinical effect of posterior pedicle screw internal fixation in the treatment of multi-segmental thoracolumbar fractures.Methods 84 patients with multi-segmental thoracolumbar fractures admitted from our hospital were randomly divided into control group （treated with posterior pedicle screw fixation）and observation group（treated with posterior approach long segment pedicle screw fixation）42 cases in each.The treatment effect of two groups of patients was compared.Results Patients in the observation group of intraoperative bleeding was significantly higher than the control group，the operation time was significantly longer than the control group，at the end of the follow-up of the anterior vertebral height， sagittal Cobb angle was significantly better than the control group，the results had significant differences（P0.05）.Conclusion Posterior long and short segment pedicle screw fixation are effective in the treatment of multiple thoracolumbar fractures，two have their own advantages and disadvantages，but relatively long segment fixation of the long-term curative effect is better. 　　Key words：Posterior pedicle screw fixation；Multilevel thoracolumbar fracture；VAS score；Oswestry disability index 　　胸腰椎骨折在骨科临床中常见的骨折类型，且多数患者为多节段损伤。目前，临床中治疗多节段胸腰椎骨折的方法主要为手术治疗，但是具体选择何种手术方式则还有待进一步的研究[1]。后路椎管弓根钉内固定是治疗胸腰椎骨折的常用方法，具体固定方式上分为长节段固定法和短节段固定法。本次研究对后路椎弓根钉内固定的两种固定方式治疗多节段胸腰椎骨折的效果做了探讨，现将结果报道如下。 　　1资料与方法 　　1.1一般资料 　　选取2015年3月～2016年3月84例多节段胸腰椎骨折患者作为研究对象，随机分为观察组和对照组，每组42例。观察组男23例，女19例；年龄20～65岁，平均年龄（33.56±4.23）岁；致伤原因：高空坠落伤10例，交通事故伤23例，重物砸伤9例；骨折部位：骨折节段相邻型30例，骨折节段不