目的:比较三种后路术式治疗胸椎爆裂骨折的疗效.方法:对82例胸腰椎爆裂骨折患者采用经骨折伤椎椎弓根置钉的六钉固定法、经骨折伤椎椎弓根置钉的四钉短节段固定法和传统的跨伤椎四钉固定法治疗,分别从伤椎前缘压缩比、矢状面Cobb角对比三种术式的治疗效果.结果:三种方法术前、术后伤椎前缘压缩比、矢状面Cobb角差异均有统计学意义(均P＜0.01),而经伤椎椎弓根置钉的六钉固定法和经骨折伤椎椎弓根置钉的四钉短节段固定法与传统的跨伤椎四钉固定法比较,差异有统计学意义(P＜0.01),但前二者之间差异无统计学意义(P＞0.05).结论:经伤椎椎弓根置钉的六钉固定法、经骨折伤椎椎弓根置钉的四钉短节段固定法治疗胸腰椎爆裂骨折疗效优于传统的跨伤椎四钉固定法,而经骨折伤椎椎弓根置钉的四钉短节段固定法更优于经伤椎椎弓根置钉的六钉固定法,但适应证有限.%Objective: To evaluate the clinical efficacy of posterior route three surgical methods for thoracolumbar burst fractures. Methods: 82 patients with thoracolumbar burst fracture were included in this study, they were treated by six and four vertebral pedicle screw fixation on fractured vertebra and traditional four pedicle screw. All the patients were divided into three groups. Three groups were comparatively analyzed from two aspects, that was fractured vertebra height compression ratio and the Cobb's angle on sagittal plane before and after surgery. Results: The fractured vertebra height compression ratio and the Cobb's angle on sagittal plane before and after surgery in three methods, there were significant differences(all P＜O.01 ). and six pedicle screw group and four pedicle screw fixation on fractured vertebrae compared to the traditional four pedicle screw group had significant differences (P＜0.01). but the two groups had no significant difference (P＞0.05).Conclusion: Six and four vertebral pedicle screw fixation on fractured vertebra is safe, effective and therapeutic options to the thoracolumbar burst fractures. And four vertebral pedicle screw fixation on fractured vertebra is better than six vertebral pedicle screw fixation on fractured vertebra but adaptation of four vertebral pedicle screw fixation on fractured vertebra is limited.
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