关键词:

胸腰椎爆裂性骨折, 椎弓根螺钉内固定, 临床效果, 生物力学 ,

Abstract:

Objective To compare the effect of transforaminal and straddling pedicle screw internal fixation in patients with thoracolumbar burst fractures. Methods A total of 86 patients with thoracolumbar burst fractures were randomly divided into traumatic vertebral group and straddling vertebra group and were treated with transpe⁃ dicular screw fixation and straddling vertebra pedicle screw internal fixation，respectively，and were followed up for 2 years. The pain，Oswestry dysfunction index（ODI），imaging index and postoperative complications，incision healing and fracture healing were compared. In addition，the biomechanical characteristics of the 2 groups were compared by biomechanical test. Results The scores of pain visual analogue scale（VAS）and ODI in the two groups were decreased successively at completion of operation，3 months after operation and the last follow ⁃ up （P < 0.05），and the compression rate of injured spine and Cobb angle of kyphosis at completion of operation，3 months after operation and the last follow⁃up were lower than before operation（P < 0.05）. However，except VAS， the above indexes in traumatic vertebra group at 3 months after operation and the last follow ⁃ up were lower than those in straddling vertebra group（P < 0.05）. There were no postoperative complications in both groups after operation，and the incision healed in Grade A and the fracture healed in both groups. The torsion angle，flexion displacement，flexion displacement and pullout strength in the traumatic vertebral group were lower than those in the straddling vertebral group（P < 0.05）. Conclusion For patients with thoracolumbar burst fractures，the strad⁃ dling screw fixation and transpedicular screw fixation all could obtain good clinical efficacy，while transpedicular screw fixation had better clinical application value.

Key words:

thoracolumbar burst fracture, pedicle screw internal fixation, clinical effect, biome? chanical properties