胸腰椎爆裂骨折手术中脊柱中柱韧带结构对手术疗效的临床意义

摘要

Objective:To explore the spine surgery ligament structural damage or not for thoracolumbar burst fracture affecting the efficacy of surgery. Methods:30 patients according to the spinal column ligament damage,were divided into the study group (stele ligament damage) with 18 cases and control group (stele ligament nondestructive) with 12 cases,the patients of two groups were given the posterior vertebral lamina decompression reset fixed surgery treatment. Results:ASIA classification of patients in study group before treatment was significantly heavier than control group,after treatment,the classification of two groups had reduced,but the classification of study group is still heavier than control group,data by comparison difference had statistical significance(P<0.05).The vertebral body form each index of patients of two groups before treatment had no significant difference(P>0.05),significantly improved after treatment(P<0.05);The vertebral rear edge height ascension size of patients in the study group was significantly lower than the control group,the improved amplitude of kyphosis Cobb Angle and spinal canal steno-sis degree was obviously poorer than the control group,data by comparison difference had statistical significance(P<0.05). Conclusion:The spinal column ligament structural damage will directly affect the patients with thoracolumbar burst of nerve function damage degree,the clinical curative effect of the patients with the stele ligament structure and fiber ring structure damage are far less than those without damage,so shall pay more attention to the clinical treatment of patients with injury of operation,and explore more method to conducive to enhance the treatment effect.%　　目的：探讨脊柱中柱韧带结构损伤与否对于胸腰椎爆裂骨折手术疗效的影响.方法：30例患者根据脊柱中柱韧带损伤情况，分为研究组(中柱韧带损伤)18例和对照组(中柱韧带无损)12例，两组患者均采用后路椎板减压复位固定手术进行治疗.结果：研究组患者治疗前 ASIA 分级程度明显较对照组重，治疗后两组分级都有所减轻，但研究组患者的分级仍然重于对照组，数据经比较差异有统计学意义(P<0.05).两组患者治疗前椎体形态各指标比较差异无统计学意义(P>0.05)，治疗后均有显著改善(P<0.05)；研究组患者椎体前、后缘高度提升尺寸明显低于对照组，脊柱后凸 Cobb 角和椎管狭窄程度改善幅度明显差于对照组，数据经比较差异有统计学意义(P<0.05).结论：脊柱中柱韧带结构损伤将直接影响到胸腰椎爆裂患者的神经功能损伤程度，对中柱韧带结构和纤维环结构损伤患者的临床疗效也远远不及未损伤者，因此临床治疗应更加重视损伤患者的手术操作，并探讨更有利于提高治疗效果的方法.