CAJ | 학술논문

目的：探讨经伤椎与跨伤椎短节段内固定术在胸腰椎骨折中的应用价值。方法将2011年5月~2013年5月期间在解放军第十二医院接受经伤椎短节段内固定术的胸腰椎骨折患者纳入观察组(45例)，将2009年5月~2011年4月接受跨伤椎短节段内固定术的胸腰椎骨折患者纳入对照组(45例)，比较两组患者的椎体情况、术中创伤、术后恢复情况和并发症情况。结果①术后，两组患者的Cobb角均低于术前、伤椎椎体前缘高度比高于术前，差异有统计学意义(P<0.05)；观察组患者术后的Cobb角[(9.3±1.1)o]小于对照组[(13.8±1.8)o]，术后椎体前缘高度比[(90.4±11.3)%]大于对照组[(84.2±9.4)%]，差异均有统计学意义(P<0.05)。②两组手术时长、手术出血量、术后卧床时间、住院总时间比较，差别无统计学意义(P>0.05)。③观察组患者术后发生螺钉松动(4.44豫)、脱出(2.22豫)和断裂(0.00豫)的发生率均少于对照组(17.78豫、13.33豫、8.89豫)，差异有统计学意义(P<0.05)。结论经伤椎短节段内固定术在矫正后凸畸形、重建椎体高度方面优于跨伤椎内固定术，在手术创伤和术后恢复方面与跨伤椎内固定术效果相当。
목적：탐토경상추여과상추단절단내고정술재흉요추골절중적응용개치。방법장2011년5월~2013년5월기간재해방군제십이의원접수경상추단절단내고정술적흉요추골절환자납입관찰조(45례)，장2009년5월~2011년4월접수과상추단절단내고정술적흉요추골절환자납입대조조(45례)，비교량조환자적추체정황、술중창상、술후회복정황화병발증정황。결과①술후，량조환자적Cobb각균저우술전、상추추체전연고도비고우술전，차이유통계학의의(P<0.05)；관찰조환자술후적Cobb각[(9.3±1.1)o]소우대조조[(13.8±1.8)o]，술후추체전연고도비[(90.4±11.3)%]대우대조조[(84.2±9.4)%]，차이균유통계학의의(P<0.05)。②량조수술시장、수술출혈량、술후와상시간、주원총시간비교，차별무통계학의의(P>0.05)。③관찰조환자술후발생라정송동(4.44예)、탈출(2.22예)화단렬(0.00예)적발생솔균소우대조조(17.78예、13.33예、8.89예)，차이유통계학의의(P<0.05)。결론경상추단절단내고정술재교정후철기형、중건추체고도방면우우과상추내고정술，재수술창상화술후회복방면여과상추내고정술효과상당。
Objective To study the application value of transpedicular and inter vertebral short segment fixation in treating thoracolumbar fractures. Methods In No.12 Hospital of PLA, from May 2011 to May 2013, 45 patients with thoracolumbar fractures received transpedicular vertebral short segment fixation were enrolled in observation group, from May 2009 to April 2011, 45 patients received inter vertebral short segment fixation were enrolled in control group. Then vertebral condition, surgical trauma and stress conditions were compared. Results ①After operation, Cobb angle of two groups were lower than those before operation and anterior edge height ratio were higher than those before opera-tion, the differences were statistically significant (P<0.05);Cobb angle of observation groups [(9.3±1.1)o] was lower than that of control group [(13.8±1.8)o], and anterior edge height ratio [(90.4±11.3)%] was higher than that of control group [(84.2±9.4)%], the differences were statistically significant (P<0.05);②there was no statistical differences between two groups of operation duration, postoperative bleeding volume, bedding time, hospitalization time (P>0.05);③ the occur-rence rates of screw loosening (4.44%), dislocation (2.22%) and fracture cases (0.00%) in observation group were less than those in control group (17.78%, 13.33%, 8.89%), the differences were statistically significant (P<0.05). Conclu-sion Transpedicular vertebral short segment fixation can effectively correct the kyphosis and reconstruct vertebral height, and achieve equal operation trauma, postoperative recovery with inter vertebral surgery.