CAJ | 학술논문

目的：探究胸腰椎骨折患者及早进行经后路间接减压及椎弓根钉内固定术对脊椎及脊髓损伤恢复的影响。方法：选取2007年6月至2012年6月来我院就诊的80例胸腰椎骨折患者，依据手术时机选择的不同分为早期组和延迟组。早期组在受伤后不耽误常规治疗措施的前提下第一时间（一般在5h内）进行经后路间接减压及椎弓根钉内固定术治疗，延迟组在处理好其他较紧急的损伤后（一般不超过3d）进行经后路间接减压及椎弓根钉内固定术治疗。结果：治疗前两组患者的各项指标比较无统计学差异（ P＞0．05）；治疗后早期组患者的排尿及排便障碍的例数明显少于延迟组（ P＜0．05），早期组的ASIA分级、简式Fugl-Meyer下肢运动功能评分、Fugl-Meyer平衡功能评分及治疗后一年能从事的劳动类型均优于延迟组（ P＜0．05）；两组患者治疗后的椎体高度比、后凸cobb’ s角较治疗前有明显好转（P＜0．05），但治疗前后组间对比未见明显差异（P＞0．05）。结论：胸腰椎骨折患者早期进行经后路间接减压及椎弓根钉内固定术可有效改善受压脊髓的恢复情况，但对椎体的恢复未见明显优势。
목적：탐구흉요추골절환자급조진행경후로간접감압급추궁근정내고정술대척추급척수손상회복적영향。방법：선취2007년6월지2012년6월래아원취진적80례흉요추골절환자，의거수술시궤선택적불동분위조기조화연지조。조기조재수상후불탐오상규치료조시적전제하제일시간（일반재5h내）진행경후로간접감압급추궁근정내고정술치료，연지조재처리호기타교긴급적손상후（일반불초과3d）진행경후로간접감압급추궁근정내고정술치료。결과：치료전량조환자적각항지표비교무통계학차이（ P＞0．05）；치료후조기조환자적배뇨급배편장애적례수명현소우연지조（ P＜0．05），조기조적ASIA분급、간식Fugl-Meyer하지운동공능평분、Fugl-Meyer평형공능평분급치료후일년능종사적노동류형균우우연지조（ P＜0．05）；량조환자치료후적추체고도비、후철cobb’ s각교치료전유명현호전（P＜0．05），단치료전후조간대비미견명현차이（P＞0．05）。결론：흉요추골절환자조기진행경후로간접감압급추궁근정내고정술가유효개선수압척수적회복정황，단대추체적회복미견명현우세。
Objective:To investigate the effect of spinal cord injury repair by early posterior indirect de-compression and pedicle screw fixation on patients with thoracolumbar fracture .Method:From June 2007 to June 2012 , 80 patients with thoracolumbar fractures were divided into groups of early and delayed groups based on the timing of surgery .The early group accepted early posterior indirect decompression and pedicle screw fixation at the first time ( within 5 hours after injury ) ,after other more urgent injury were cured ,the de-layed group accepted early posterior indirect decompression and pedicle screw fixation ( within 3 days after injury).Result: After treatment,the number of urination and defecation disorder of patients in the early group were significantly less than the delayed group (P <0.05).The ASIA scale, simplified Fugl-Meyer low-er extremity motor function score , Fugl-Meyer balance function score and the types of labor after one year were all better than the delayed group ( P <0.05) .Vertebral height ratio , kyphosis cobb's corner were all bet-ter than before ( P <0.05) ,but there was no significant difference between the two groups after treatment ( P>0.05) .Conclusion: The early posterior indirect decompression and pedicle screw fixation can effectively improve the recovery of spinal cord compression on the patients with thoracolumbar fracture , but no obvious advantage to restore vertebral body .