CAJ | 학술논문

目的对比前后路手术治疗胸腰椎爆裂性骨折合并脊髓损伤的疗效。方法2010-01-2012-12收治49例胸腰椎爆裂性骨折患者分为 A组23例和B组26例。A组行前入路锥体次全切除，钛网重建内固定手术；B组行后入路椎体次全切除，钛网重建内固定术。对比2组治疗效果。结果2组术中出血量、手术时间、术后神经功能比较差异无统计学意义（P＞0.05）；而术后 VAS评分B组优于A组（P＜0.05）；A组末次随访（术后9个月）时Cobb角恢复优于B组（P＜0.05）；2组均无严重并发症。结论前后路手术治疗胸腰椎爆裂性骨折合并脊髓神经损伤疗效相当，根据患者的个体情况，合理选择手术入路，有助于提高临床疗效。
목적대비전후로수술치료흉요추폭렬성골절합병척수손상적료효。방법2010-01-2012-12수치49례흉요추폭렬성골절환자분위 A조23례화B조26례。A조행전입로추체차전절제，태망중건내고정수술；B조행후입로추체차전절제，태망중건내고정술。대비2조치료효과。결과2조술중출혈량、수술시간、술후신경공능비교차이무통계학의의（P＞0.05）；이술후 VAS평분B조우우A조（P＜0.05）；A조말차수방（술후9개월）시Cobb각회복우우B조（P＜0.05）；2조균무엄중병발증。결론전후로수술치료흉요추폭렬성골절합병척수신경손상료효상당，근거환자적개체정황，합리선택수술입로，유조우제고림상료효。
Objective To observe the results of posterior and anterior reconstructions with subtotal vertebrectomy,de-compression and internal fixation for severe thoracolumbar veterbrae burst fractures.Methods 49 patients of thoracolumbar veterbra burst fractures from Jan 2010 to Dec 2012 were divided into A group (23 patients)and B group (26 patients).A group received posterior approach for spine reconstruction with subtotal vertebrectomy decompression and internal fixation and B group received anterior approach for spine reconstruction with subtotal vertebrectomy decompression and internal fixation.The clinical effects of the two groups were compared.Results There was not significantly different between the two groups in intra-operative blood loss,operation time,ASIA scores,the heights of anterior edge of vertebral body (P>0.05);At post-opera-tion,the VAS score of B group was signifieantly lower than that of A group.Conclusion The posterior surgical treatment of thoracolumbar burst fracture complicated with spinal cord inj ury shows equivalent clinical effects with the anterior surgery, both kinds of surgery can restore vertebrae height,correct local kyphosis and improve nerve function.