CAJ | 학술논문

【目的】比较经前路与经后路椎体次全切除减压内固定术治疗胸腰椎爆裂性骨折患者的临床疗效。【方法】对本院经前、后路椎体次全切除减压内固定的170例胸腰椎爆裂性骨折患者临床资料进行回顾性分析。A组：经前路椎体次全切除并采用钛网内固定80例，B组：经后路椎体次全切除并采用钛网内固定90例，采用ASIA评分法对两组患者手术前后神经功能分级进行评价，对比两组患者术后临床效果。【结果】两组患者在手术时间、出血量、手术前后ASIA评级和椎体前缘高度方面比较差异无显著性（ P ＞0．05）。术后B组患者肺功能指标明显高于A组，且VAS 评分则明显低于A组；术后1年复查，B组Cobb角明显大于A组，差异均具有统计学意义（ P＜0．05）。【结论】经后路椎体次全切除减压内固定手术较前路椎体次全切除减压内固定手术能有效减轻胸腰椎爆裂性骨折患者术后的痛苦，对术后肺功能影响小，是相对安全有效的手术方式。
【목적】비교경전로여경후로추체차전절제감압내고정술치료흉요추폭렬성골절환자적림상료효。【방법】대본원경전、후로추체차전절제감압내고정적170례흉요추폭렬성골절환자림상자료진행회고성분석。A조：경전로추체차전절제병채용태망내고정80례，B조：경후로추체차전절제병채용태망내고정90례，채용ASIA평분법대량조환자수술전후신경공능분급진행평개，대비량조환자술후림상효과。【결과】량조환자재수술시간、출혈량、수술전후ASIA평급화추체전연고도방면비교차이무현저성（ P ＞0．05）。술후B조환자폐공능지표명현고우A조，차VAS 평분칙명현저우A조；술후1년복사，B조Cobb각명현대우A조，차이균구유통계학의의（ P＜0．05）。【결론】경후로추체차전절제감압내고정수술교전로추체차전절제감압내고정수술능유효감경흉요추폭렬성골절환자술후적통고，대술후폐공능영향소，시상대안전유효적수술방식。
[Objective] To comparatively analyze the clinical efficacies of anterior versus posterior corpec‐tomy ,decompression and internal fixation for patients with thoracolumbar burst fracture .[Methods] A total of 170 patients with thoracolumbar burst fracture underwent anterior ( n=80) versus posterior ( n=90) ver‐tebral corpectomy ,decompression and internal fixation with titanium mesh .And the American Spinal Injury Association (ASIA) score was adopted to evaluate the neurologic evaluation grading of two groups before and after surgery .And two groups were compared with regards to intraoperative volume of blood loss ,operative duration ,pain degree and vertebral height .[Results] The inter‐group differences were not statistically signifi‐cant in operative duration ,volume of blood loss ,surgical American Spinal Injury Association (ASIA) rating and anterior flange height before and after surgery .The postoperative lung function index of group B was sig‐nificantly higher than that of group A .And VAS scores of group B were significantly lower than those of group A .At 1 year postoperation ,Cobb angle of group B was significantly greater than that of group A .And the difference had statistical significance ( P <0 .05) .[Conclusion] As compared with anterior corpectomy , posterior corpectomy can effectively relieve postoperative suffering of patients with thoracolumbar burst frac‐ture .With a less impact on postoperative pulmonary function ,it is both safe and effective .