CAJ | 학술논문

目的：探讨胸腰椎 B 型骨折患者采用经伤椎置钉单椎间椎弓根螺钉复位固定治疗的临床效果。方法回顾性分析骨科2010年2月年至2013年2月收治的86例 AO 分型为 B 型的胸腰椎骨折患者的临床资料，根据手术方式分为经伤椎置钉单椎间椎弓根螺钉复位固定治疗（研究组41例）和传统跨伤椎短节段固定治疗（对照组45例），比较2组患者术前与术后不同时间的疼痛评分、Cobb 角、前缘压缩率、ASIA 神经功能分级及 ODI 评分变化情况。结果研究组的手术时间、术中出血量、椎体前缘压缩率术后1个月及末次随访显著低于对照组（ P <0.05）；研究组的住院时间、随访时间、术前椎体前缘压缩率与对照组比较差异无统计学意义（ P >0.05）。研究组的 VAS 评分、Cobb角、ODI 评分在术前及术后1个月比较差异无统计学意义（P >0.05），研究组末次随访时的 VAS 评分、Cobb 角、ODI 评分显著的低于对照组（ P <0.05）。治疗前、末次随访2组患者间的 ASIA 分布差异无统计学意义（ P >0.05）；治疗后2组患者的 ASIA 均优于治疗前（ P <0.05）。结论胸腰椎 B 型骨折患者采用经伤椎置钉单椎间椎弓根螺钉复位固定治疗手术时间短、术中出血量少、同时降低术后 VAS 评分、Cobb 角丢失及椎间盘退变的优点。
목적：탐토흉요추 B 형골절환자채용경상추치정단추간추궁근라정복위고정치료적림상효과。방법회고성분석골과2010년2월년지2013년2월수치적86례 AO 분형위 B 형적흉요추골절환자적림상자료，근거수술방식분위경상추치정단추간추궁근라정복위고정치료（연구조41례）화전통과상추단절단고정치료（대조조45례），비교2조환자술전여술후불동시간적동통평분、Cobb 각、전연압축솔、ASIA 신경공능분급급 ODI 평분변화정황。결과연구조적수술시간、술중출혈량、추체전연압축솔술후1개월급말차수방현저저우대조조（ P <0.05）；연구조적주원시간、수방시간、술전추체전연압축솔여대조조비교차이무통계학의의（ P >0.05）。연구조적 VAS 평분、Cobb각、ODI 평분재술전급술후1개월비교차이무통계학의의（P >0.05），연구조말차수방시적 VAS 평분、Cobb 각、ODI 평분현저적저우대조조（ P <0.05）。치료전、말차수방2조환자간적 ASIA 분포차이무통계학의의（ P >0.05）；치료후2조환자적 ASIA 균우우치료전（ P <0.05）。결론흉요추 B 형골절환자채용경상추치정단추간추궁근라정복위고정치료수술시간단、술중출혈량소、동시강저술후 VAS 평분、Cobb 각주실급추간반퇴변적우점。
Objective To investigate the therapeutic effect of posterior vertebral pedicle screw and single Shima Shiumine screw reduction fixation on traumatic type B thoracolumbar fracture. Methods The clinical data about 86 patients with traumatic type B thoracolumbar fracture who were admitted into our hospital were retrospectively analyzed. These patients were divided into two groups according to the operation mode:observation group(n = 41)and control group( n = 45). The patients in observation group were treated by posterior vertebral pedicle screw and single Shima Shiumine screw fixation, however,the patients in control group were treated by traditional across the injured vertebra short segment fixation. The pain score in different time points,Cobb angle and centrum anterior border compression ratio,ASIA neural function grading and ODI score before and after treatment were observed and compared between the two groups. Results The operation time,hemorrhage volume during operation and one month after operation and the last fouow-up in observation group were significantly lower than those in control group( P < 0. 05). However there were no significant differences in hospitalization time,follow-up time and centrum anterior border compression ratio there were no significant differences in VAS score,Cobb angle and ODI score before operation and one month after operation between two groups( P > 0. 05),but VAS score,Cobb angle and ODI score in the last follow-up in observation group were significantly lower than those in control group( P < 0. 05). There was no significant difference in ASIA distribution before operation and one year after treatment between two groups( P > 0. 05),however,the ASIA distribution before treatment was superior to that after treatment for both groups(P < 0. 05). Conclusion The posterior vertebral pedicle screw and single Shima Shiumine screw reduction fixation in treatment of traumatic type B thoracolumbar frac-ture has the advantages of decreasing postoperative VAS score,Cobb angle loss and degeneration of intervertebral disc,with shorter operation time and less hemorrhage volume during operation.