摘要
[目的]探讨侧前入路及后侧入路截骨矫正创伤性单节段胸腰段后凸畸形的疗效及安全性。[方法]回顾性分析2010年1月~2013年1月,37例单节段胸腰段后凸畸形患者资料,其中20例采用侧前入路行手术矫正(侧前入路组),17例采用后侧入路矫正固定(后侧入路组)。比较两组相关围手术期与随访资料。[结果]侧前入路组较后侧入路组手术时间短,手术费用及出血量少,差异有统计学意义(P<0.05)。所有患者至少随访1年,采用Stauffer-Coventry(SC)评价标准,大部分患者的临床症状得到明显改善,按ASIA神经功能评级,所有神经功能得到明显恢复,但两组间差异无统计学意义(P>0.05)。与术前相比,两组术后1个月、术后1年时VAS评分、ODI指数、JOA评分、SF-36均有显著改善,差异均有统计学意义(P<0.05);但相同时间点两组间比较差异均无统计学意义(P>0.05)。术前比较,所有患者术后1个月、术后1年伤椎Cobb角明显减小,时间点间差异均有统计学意义(P<0.05),但相同时间点两组间比较差异均无统计学意义(P>0.05)。两组患者的骨性愈合率差异无统计学意义(P>0.05)。[结论]两种手术入路方式均为治疗胸腰段创伤性后凸畸形的有效方式,临床疗效无显著差异。但侧前方入路手术时间短、花费少。
[Objective] To compare the clinical outcomes of anterolateral versus posterior procedure for surgical correction of traumatic thoracolumbar kyphosis. [Methods] From January 2010 to Jan,ary 2013, 37 patients with single-segment thnracolumbar kyphosis secondary to trauma were surgically treated. Of them, 20 patients received anterolateral procedure for surgical correction （the anterolateral group） , whereas the remaining 17 patients underwent surgical correction by posterior technique （the posterior group） . Operation time. intraoperative blood loss, cost of treatment, ASIA grade, Stauffer-Coventry （SC） scale, VAS, ODI, SF-36 score and JOA score, compared between the two groups. In addition, X-ray and sagittal CT reconstruction were taken for measurement of Cobb angle and evaluation of spinal fusion. [Results] The anterolateral group had significantly shorter operation time, less intraoperative blood loss and lower operation cost than the posterior group （P〈0.05） . All the patients were followed up for at least one year. In term of Stauffer-Coventry. criteria and ASIA grade, most the patients achieved significant improvement in clinical manifestation and neurologic function, however, no statistical difference was noted between the two groups. Compared with the data before operation, VAS , ODI, SF-36 and JOA score significantly improved in both group at 1 month and 1 year postoperatively （P〈0.05） , but no significant difference was found at the same time point in any aforesaid parameters between the 2 groups （P〉0.05） . Furthermore. the Cobb angle significantly decreased ＇after operation in both group （P〈0.05） , whereas no significant difference was noted in the Cobb angle at the same time point, and fusion rate at the latest follow up between the two groups （P〉0.05） . [Conclusion] Both anterolateral and posterior surgical procedures are safe and effective for treatment of traumatic thoracolumbar kyphosis, associated with similar clinical outcome. However. the anterolateral technique has advantage of shorter operation time, less blood loss and lower operative cost than the posterior operation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第21期1938-1943,共6页
Orthopedic Journal of China
关键词
胸腰椎骨折
后凸畸形
手术矫正
侧前路手术
后路手术
thoracolumbar fracture, kyphosis, surgical correction, anterolateral approach, posterior approach
