不同后路内固定方法对脊椎爆裂性骨折中的效果比较

摘要

目的：比较不同后路内固定方法对脊椎爆裂性骨折中的效果。方法选取2010年6月-2012年10月于进行后路内固定手术治疗的54例脊椎爆裂性骨折为研究对象，将其随机分为A组（Dick系统组）27例和B组（AF系统组）27例，两组均以后路减压及植骨术进行资料，而A组在此基础上以Dick钉治疗，B组则以AF系统进行治疗，比较两组患者手术前后的椎体复位效果和Frankle评分。结果 B组治疗后1个月与6个月的椎体高度比、后凸畸形度及椎管占位率分别为（93.86±3.79）%、（94.34±3.85）%、（16.12±1.61）°、（15.98±1.58）°和（18.34±1.82）%、（18.10±1.65）%，Frankle评分A～B级比例3.70%和0.00%，其均分别优于治疗前，并且优于A组治疗后1个月与6个月，差异均有统计学意义（均P＜0.05）。结论 AF系统在脊椎爆裂性骨折中的应用效果好于Dick系统，可有效复位骨折及改善患者的神经功能状态。%Objective To compare the effect of different posterior internal fixation method in patients with vertebral burst fracture. Methods 54 patients with vertebral burst fracture and treated with posterior internal fixation in our hospital from June 2010 to October 2012 were selected as research object,and they were randomly divided into group A(Dick system group)27 cases and group B(AF system group)27 cases,the two groups were treated with posterior decompression and bone grafting,the group A were treated with Dick nail based on the treatment,the group B were treated with AF system,then the vertebral reset effect and Frankle score of two groups before and after the treatment were compared. Results The vertebral height ratio,kyphotic deformity degree and occupying ratio of group B at first and sixth month after the treatment were respectively (93.86±3.79)%, (94.34±3.85)%,(16.12±1.61)°,(15.98±1.58)° and (18.34±1.82)%,(18.10±1.65)%,A to B rate of Frankle score were 3.70%and 0.00%,and they were all better than those before the treatment,those results were better than those of group A at first and sixth month after the treatment too(all P<0.05),there were all significant differences. Conclusion The application effect of AF system in patients with vertebral burst fracture is better than that of Dick system,and it can effectively reset the fracture and improve the neurological status of patients.