胸腰椎骨折减压手术后病人脊髓压迫症状的改善效果

摘要

Aim: To analysis the effectiveness and related factors of treating neurological deficits thoracolumbar fracture patients after sugery.Methods:Modified Frankel Grading System was used to asses the neurolngical deficits of patients and the prognosis after operation. Results: Afteroperation all the patients' Frankel grade improved 1 or 2. The lower the fracture level, the better the improvement. The obvious effectiveness by anterior decompression operation was 32%, which was higher than by postenrior. According to the result of multivariable analysis, the probability of getting 2 Frankel grades improvement after surgery was statistical significantly higher in lumbar spinal fracture than in thoracispinal fracture (OR =21, P < 0.01 ), and statistical significantly higher by anterior operation than by posterior operation ( OR = 3.0, P < 0.05). Conclusion: The neurological deficits would improve after decompression in thoracolumbar fracture patients. The fracture level and the kind of operation are the main factors to affect the improvement. The improvement is obviously better in lumbar spinal fracture and anterior operation.%目的：分析胸腰椎骨折伴神经症状病人的手术效果及影响疗效的因素。方法：用Frankel分级法评价病人神经损伤的严重程度及治疗效果。结果：术后病人的Frankel分级均上升1～2级有改善。骨折水平越低，疗效越明显，腰椎骨折显效率为40％，高于胸椎骨折。前路术的显效率为32％，后路术为17％。多因素分析结果病人术后Frankel分级上升2级的可能性在腰椎骨折是胸椎骨折病人的21倍(P<0.01)，采用前路手术是后路术的3.9倍(P<0.05)。结论：胸腰椎骨折病人减压术后神经症状均得到改善，骨折部位和手术方式是影响疗效的主要因素，腰椎骨折术后神经症状改善较胸椎骨折明显，采用前路手术效果比后路手术好。