郑阳民 代玉娇

【摘 要】目的：观察分析胸腰椎多节段脊柱骨折患者采用手术治疗的临床效果。方法：筛选我院2017年1月至2019年1月治疗的80例胸腰椎多节段脊柱骨折患者进行分组研究，随机抽签分成对照组和观察组，均为40例。观察组患者采用前路手术治疗方案;对照组患者采用后路手术治疗方案。观察两组患者椎体前缘高度与后凸角度数，比较手术治疗效果及并发症发生率。结果：经前路手术治疗，观察组患者椎体前缘高度与后凸角改善良好，效果优于对照组，差异均有统计学意义（p<0.05）;观察组相关并发症发生率显著低于对照组，组间差异有统计学意义（p<0.05）。结论：胸腰椎多节段脊柱骨折患者采用前路手术方案治疗效果明显优于后路手术，可积极改善患椎前缘高度、后凸角度数，有利于脊柱序列恢复，且并发症风险较小，有较高应用价值。

【关键词】胸腰椎;脊柱骨折;前路手术

【Abstract】Objective： To observe and analyze the clinical effects of surgical treatment for patients with thoracolumbar spine fractures. Methods： Eighty patients with thoracolumbar spine with multi-segmental spine fractures treated from January 2017 to January 2019 in our hospital were divided into two groups： the control group and the observation group，with 40 cases in each group. Patients in the observation group were treated with anterior surgery; patients in the control group were treated with posterior surgery. The anterior height of the vertebral body and the number of kyphosis angles were observed in the two groups， and the surgical treatment effect and the incidence of complications were compared. Results： After anterior surgery， the anterior height and kyphosis of the vertebral body improved well in the observation group， and the effect was better than the control group. The difference was statistically significant （p<0.05）. The incidence of complications was significantly lower in the observation group. In the control group， the difference between the groups was statistically significant （p<0.05）. Conclusion： Patients with thoracolumbar spine fractures with anterior approach are better than posterior surgery. They can positively improve the height of the anterior border and the number of kyphosis， which is beneficial to the recovery of the spine sequence and the risk of complications is small. And there is a higher application value.

【Key words】thoracolumbar spine; spinal fracture; anterior surgery

人在外力或者暴力的作用下，很容易發生胸腰椎多节段脊柱骨折。该疾病在所有脊柱骨折类型中占比约为40%[1]。对其的临床治疗首选手术方式，通过对患者应用手术的手段，既可以保证骨折部位在短期内得到稳定固定，又可以促进骨折的椎体快速愈合，避免对神经的进一步损害[2]。然而在手术方式的选择上却出现了一定的争议，主要集中在入路方案的处理上。为探究不同入路手术方式所体现出的治疗效果，本文将通过对照试验的方法进行总结，并将研究结果报告如下。

1 资料与方法

1.1 一般资料

筛选我院2017年1月至2019年1月治疗的80例胸腰椎多节段脊柱骨折患者进行分组研究，随机抽签分成对照组和观察组，均为40例。其中观察组中男24例，女16例。年龄为20～65岁，平均年龄（38±1.5）岁。骨折原因包括高空坠伤11例，交通意外伤25例，压砸伤4例;对照组中男25例，女15例。……