后路椎弓根内固定联合前路减压植骨术分期治疗胸腰椎爆裂性骨折的疗效观察
Chinese Journal of Primary Medicine and Pharmacy(2015)
Abstract
目的:探讨后路椎弓根钉内固定、前路减压植骨术分期治疗合并多发伤的胸腰椎爆裂性骨折的临床疗效。方法回顾性分析53例行分期后前路手术治疗的单节段胸腰椎爆裂性骨折患者,比较术前及末次随访时伤椎压缩高度比、Cobb 角及椎管容积,应用 Frankel 评分评估神经功能恢复情况,Fugl-Meyer 评分评价运动功能的改善。结果共有49例患者获得随访。末次随访时,患者的伤椎压缩高度比、Cobb 角及椎管容积均较术前明显改善(t =24.047,P <0.01;t =21.815,P <0.01;t =31.699,P <0.01)。术前,Frankel 分级为:A 级6例,B 级18例,C 级15例,D 级10例,E 级4例;末次随访时,分别为3例、8例、11例、17例和10例,治疗后神经功能评分较前明显改善(Z =2.997,P =0.003)。治疗前,Fugl-Meyer 平均分为(74.65±8.42)分,末次随访时为(90.26±9.17)分,术后患者的运动功能评分明显升高(t =8.963,P <0.01)。结论Ⅰ期行后路椎弓根钉内固定,Ⅱ期行前路减压植骨术治疗合并多发伤的胸腰椎爆裂性骨折,临床疗效确切,有利于运动和脊髓功能的恢复。
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Key words
Spinal fractures,Fracture fixation,Decompression,surgery
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