Objective To investigate the effects of different surgical approaches to treat severe lumbar unstable fractures. Methods 80 patients of severe lumbar unstable fractures were divided into the treatment group( 40 cases ) and the control group ( 40 cases ). Patients of the control group were given posterior surgery only, while patients of the treatment group were given combined surgical approaches at the same time. Results The operative time, blood loss, drainage volume of the treatment group were more than that of the control group, but there was no significant difference ( P > 0. 05 ). The vertebral compression rate and Cobb angle before treatment had no significant difference before the treatment, but there was a significantly difference after the treatment ( P <0. 05 ). Through observation we find that the recovery rate of the treatment group was 95. 0% , and the control group was 77. 5% . The efficacy of the treatment group was obviously better than that of the control group ( P <0. 05 ). Conclusion When using combined surgical approach there was no obvious trauma increase, and the Cobb angle and vertebral height compression ratio could be reduced significantly. So combined surgical approach could be a good way to increase the recovery rate. But the operative techniques should be strictly controlled.%目的 对比不同入路手术方式治疗严重腰椎不稳定型骨折的效果.方法 将80例严重腰椎不稳定型骨折患者根据入院顺序随机分为实验组40例与对照组40例,对照组单独采用后路手术,实验组采用前后联合入路手术.结果 实验组的手术时间、出血量、引流量多于对照组,但无显著差异 (P>0.05).两组术前椎体压缩率及Cobb角无明显差异,术后都有明显下降,但是两组对比有明显差异(P<0.05).实验组的好转率为95.0%,对照组好转率为77.5%,实验组的疗效明显好于对照组(P<0.05).结论 前后联合入路手术治疗严重腰椎不稳定型骨折并不明显增加创伤,同时可明显降低Cobb角与椎体前缘高度压缩率,从而增加治疗好转率,但是应严格掌握手术操作技术.
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