背景：后路减压内固定修复胸腰椎骨折效果肯定，又根据处理方法的不同分为短节段与长节段椎弓根螺钉内固定。目前临床上关于两种修复方案的疗效，存在较大争议。目的：对比观察经后路短节段与长节段椎弓根螺钉置入内固定修复胸腰椎骨折患者的伤椎前缘压缩率及Cobb角变化率。方法：纳入胸腰椎骨折患者120例，根据内固定方案分为两组，研究组采用经后路短节段椎弓根螺钉内固定，对照组采用经后路长节段椎弓根螺钉内固定。观察两组患者内固定前、内固定后即刻、内固定后12个月伤椎前缘压缩率以及Cobb角变化率。结果与结论：内固定前两组患者伤椎前缘压缩率、Cobb角变化率差异均无显著性意义(P >0.05)。内固定后即刻及内固定后12个月，可见研究组伤椎前缘压缩率、Cobb角变化率均明显小于对照组，差异均有显著性意义(P <0.05)。此外，研究组患者手术时间、失血量均少于对照组，差异均有显著性意义(P <0.05)。提示经后路短节段椎弓根螺钉置入内固定修复胸腰椎骨折能够有效改善后凸畸形，恢复椎体压缩度，且手术时间短，术中出血量少，优于经后路长节段椎弓根螺钉置入内固定治疗。%BACKGROUND:The effects of posterior decompression fixation in the repair of thoracolumbar fracture are affirmative. The fixation was divided into short-segment and long-segment pedicle screw fixation according to different treatment methods. The therapeutic effects of above two methods are controversial in the clinic at present. OBJECTIVE:To compare and observe the anterior vertebral compression ratio and the changes in Cobb angle after posterior short-segment and long-segment pedicle screw placement fixation in the repair of thoracolumbar fracture. METHODS:120 patients with thoracolumbar fracture were enrol ed in this study, and assigned to two groups according to fixation methods. Study group received posterior short-segment pedicle screw fixation. Control group received posterior long-segment pedicle screw fixation. Anterior vertebral compression rate and Cobb angle were observed before fixation, immediately and 12 months after fixation in both groups. RESULTS AND CONCLUSION:There was no significant difference in anterior vertebral compression rate and Cobb angle between the two groups before fixation (P>0.05). Anterior vertebral compression rate and Cobb angle were significantly smal er in the study group than in the control group immediately and 12 months after fixation (P<0.05). Besides, surgical time and blood loss volume were less in the study group than in the control group (P<0.05). These results indicated that posterior short-segment pedicle screw fixation for treatment of thoracolumbar fracture can effectively improve kyphosis, recover vertebral compression degree, and its surgical time is short and blood loss volume during surgery is little, so it is better than posterior long-segment pedicle screw fixation.
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