CAJ | 학술논문

目的：探讨脊柱中柱韧带结构损伤对于胸腰椎爆裂骨折手术疗效的影响。方法选择从2010年3月~2013年3月于本院就诊的38例胸腰椎爆裂性骨折伴脊柱中柱韧带结构损伤患者作为研究组,另选择同时期的未伴有脊柱中柱韧带结构损伤的胸腰椎爆裂性骨折患者作为对照组,两组患者均采用后路椎板减压复位固定手术进行治疗。观察两组患者治疗前后ASIA神经功能损伤评级情况、损伤椎体形态变化情况及日常生活活动能力量表评分情况。结果治疗前研究组患者的损伤分级较对照组重,差异有统计学意义(χ2=5.83, P<0.05),而治疗后研究组患者的ASIA神经功能损伤评级仍较对照组严重,差异有统计学意义(χ2=7.41, P<0.05)；两组患者手术前椎体形态各指标比较,差异均无统计学意义(P>0.05),均在术后有不同程度的改善,差异有统计学意义(P<0.05)；但研究组患者椎体形态的改善情况明显差于对照组,差异有统计学意义(P<0.05)；研究组患者术前Barthel指数低于对照组患者,术后依旧低于对照组,差异有统计学意义(P<0.05)。结论脊柱中柱韧带结构损伤与否对于胸腰椎爆裂骨折患者术后的神经功能有很大的影响,需要仔细对待,避免进一步损伤。
목적：탐토척주중주인대결구손상대우흉요추폭렬골절수술료효적영향。방법선택종2010년3월~2013년3월우본원취진적38례흉요추폭렬성골절반척주중주인대결구손상환자작위연구조,령선택동시기적미반유척주중주인대결구손상적흉요추폭렬성골절환자작위대조조,량조환자균채용후로추판감압복위고정수술진행치료。관찰량조환자치료전후ASIA신경공능손상평급정황、손상추체형태변화정황급일상생활활동능역량표평분정황。결과치료전연구조환자적손상분급교대조조중,차이유통계학의의(χ2=5.83, P<0.05),이치료후연구조환자적ASIA신경공능손상평급잉교대조조엄중,차이유통계학의의(χ2=7.41, P<0.05)；량조환자수술전추체형태각지표비교,차이균무통계학의의(P>0.05),균재술후유불동정도적개선,차이유통계학의의(P<0.05)；단연구조환자추체형태적개선정황명현차우대조조,차이유통계학의의(P<0.05)；연구조환자술전Barthel지수저우대조조환자,술후의구저우대조조,차이유통계학의의(P<0.05)。결론척주중주인대결구손상여부대우흉요추폭렬골절환자술후적신경공능유흔대적영향,수요자세대대,피면진일보손상。
Objective To analyze the effect of spinal column ligament injury on thoracolumbar burst fracture surgery. Methods 38 cases of thoracolumbar burst fracture with spinal column ligamentous structures injury patients were selected from March 2010 to March 2013 in our hospital as the study group, and the other options in the same period were not accompanied as the control group, and two groups of patients were treated with posterior laminectomy fixation surgery. Observed ASIA neurological dysfunction rating situation, damage vertebral body shape changes and activities of daily living scale score situation before and after treatment. Results Study group of patients with injury scales were heavier than the control group before and after treatment, the difference was statistically significant (P<0.05);the study group patients with vertebral morphology to improve were worse than the control group (P<0.05);study group of patients before and after surgery, Barthel scores were lower than the control group of patients, the difference was statistically significant (P<0.05). Conclusions If or not the spinal column ligament injury for patients with thoracolumbar burst fractures has a great influence in nerve function after surgery, so it needed to be treated carefully, and to avoid further damage.