CAJ | 학술논문

目的：探讨后路复位内固定、经椎弓根伤椎植骨置钉治疗胸腰椎骨折的临床疗效。方法将40例胸腰椎骨折患者随机分为实验组20例和对照组20例，实验组行后路复位内固定、经椎弓根伤椎植骨置钉术，对照组行后路复位内固定、跨伤椎椎弓根置钉，术后随访1年。比较两组患者手术一般情况、手术前后患者Cobb角、椎体前缘压缩比、椎管侵占率，并于术后1年评价两组患者神经功能恢复情况。结果实验组手术时间、术中出血量显著高于对照组（P<0.05），两组术后引流量、住院时间、骨折愈合时间等比较差异无统计学意义（ P >0.05）。两组患者术后后凸Cobb角、椎管侵占率显著降低，椎体前缘压缩比显著增加（ P <0.05），手术后各时段实验组后凸Cobb角、侵占率显著低于对照组，椎体前缘压缩比显著高于对照组（ P <0.05）。术后1年实验组B级所占比率显著低于对照组，E级所占比率显著高于对照组，两组间比较差异具有统计学意义（ P <0.05）；两组患者术后并发症发生率比较差异无统计学意义（ P >0.05）。结论后路复位内固定、经椎弓根伤椎植骨置钉在伤椎复位、重建椎体高度和矫治后突畸形方面具有显著优势，且并发症发生率低，术后神经功能恢复更佳，值得临床推广。
목적：탐토후로복위내고정、경추궁근상추식골치정치료흉요추골절적림상료효。방법장40례흉요추골절환자수궤분위실험조20례화대조조20례，실험조행후로복위내고정、경추궁근상추식골치정술，대조조행후로복위내고정、과상추추궁근치정，술후수방1년。비교량조환자수술일반정황、수술전후환자Cobb각、추체전연압축비、추관침점솔，병우술후1년평개량조환자신경공능회복정황。결과실험조수술시간、술중출혈량현저고우대조조（P<0.05），량조술후인류량、주원시간、골절유합시간등비교차이무통계학의의（ P >0.05）。량조환자술후후철Cobb각、추관침점솔현저강저，추체전연압축비현저증가（ P <0.05），수술후각시단실험조후철Cobb각、침점솔현저저우대조조，추체전연압축비현저고우대조조（ P <0.05）。술후1년실험조B급소점비솔현저저우대조조，E급소점비솔현저고우대조조，량조간비교차이구유통계학의의（ P <0.05）；량조환자술후병발증발생솔비교차이무통계학의의（ P >0.05）。결론후로복위내고정、경추궁근상추식골치정재상추복위、중건추체고도화교치후돌기형방면구유현저우세，차병발증발생솔저，술후신경공능회복경가，치득림상추엄。
Objective To explore the clinical efficacy of patients with thoracolumbar fractures treated with bone graft and vertebral pedicle screw in fractured vertebrae. Methods A total of 40 patients with thoracolumbar fractures were randomly divided into experimental group(20 ca-ses)and control group(20 cases),patients in experimental group underwent bone graft and vertebral pedicle screw in fractured vertebrae,patients in control group were treated with routine fixation strode over fractured vertebrae,and all patients were followed up for 1 year. Cobb angle,com-pression ratio of anterior vertebral compression ratio,and spinal canal occupation rate were compared between these 2 groups before and after opera-tion,and recovery in neurological function of patients in these two groups had been evaluated in one year after the treatment. Results The operat-ing time and amount of intraoperative bleeding in patients of experimental group were significantly higher than those of patients in control group( P <0. 05),and the difference in drainage,hospitalization time and healing time of fracture between these 2 groups was not statistically significant ( P >0. 05). The Cobb angle and encroachment rate of spinal canal were significantly reduced in patients of these 2 groups before and after the operation,and the compression ratio of vertebral bodies had been significantly increased( P <0. 05). The Cobb angle and the rate of occupation in spinal canal in each period after operation were significantly lower than those of control group,and the anterior vertebral compression ratio was significantly higher than that of control group( P <0. 05). The proportion of B grade in experimental group in 1 year after the operation was sig-nificantly lower than that of control group,the proportion of Grade E was significantly higher than that of control group( P <0. 05),and the difference in rate of postoperative complications between these two groups of patients was not statistically significant( P >0. 05). Conclusion The application of bone graft and vertebral pedicle screw in treatment of fractured vertebrae has significant advantages in reduction of injured verte-bral bodies,reconstruction of vertebral height and correction of deformity,and the incidence of complications is low,and the recovery of neurologi-cal function is better,hence it is worthy to be applied for clinical promotion.