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胸腰椎损伤分类与严重程度评分(TLICS)为4分的胸腰椎骨折患者手术与非手术治疗效果比较:一项随机、单盲、单中心临床试验

Comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with Score 4 of TLICS: A randomized, single-blind, and single-central clinical trial.

作者信息

Mohamadi Alireza, Googanian Ali, Ahmadi Ali, Kamali Alireza

机构信息

Department of Neurosurgery Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran.

出版信息

Medicine (Baltimore). 2018 Feb;97(6):e9842. doi: 10.1097/MD.0000000000009842.

Abstract

BACKGROUND

Thoracolumbar fractures are among the most common types of damages caused to the spinal cord .Therefore, the aim of this study was the comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with score 4 of the thoracolumbar injury classification and severity (TLICS) METHODS:: This study was clinical trial and double blind. Patients with thoracolumbar fracture with score 4 of TLICS entered at this research. We divided patients in 2 groups randomly (each group 25 patients) and then we followed patients for 1 year after start of treatment. We checked duration of bedridden and absence work, pain every 3 months for 1 year and radiography every 3 months for 1 year.

RESULTS

Pain in operative group was lower than nonoperative group (P = .02). Regional sagittal angles (RSA) in operative group was lower than nonoperative group in all time (P = .0001). Mean of time of return to work in operative group was lower than nonoperative group (P = .001).

CONCLUSIONS

Pain and mean of time of return to work and RSA in operative group was lower than nonoperative group. The present data suggest the use of operative method in patients with thoracolumbar fracture with score 4 of TLICS.

摘要

背景

胸腰椎骨折是脊髓损伤最常见的类型之一。因此,本研究的目的是比较胸腰椎损伤分类及严重程度评分(TLICS)为4分的胸腰椎骨折患者手术治疗与非手术治疗的效果。

方法

本研究为临床试验且采用双盲法。TLICS评分为4分的胸腰椎骨折患者纳入本研究。我们将患者随机分为两组(每组25例患者),然后在治疗开始后对患者进行1年的随访。我们每3个月检查1年的卧床时间和缺勤情况、疼痛情况,并每3个月进行1年的影像学检查。

结果

手术组的疼痛程度低于非手术组(P = 0.02)。手术组的局部矢状角(RSA)在所有时间均低于非手术组(P = 0.0001)。手术组的平均重返工作时间低于非手术组(P = 0.001)。

结论

手术组的疼痛程度、平均重返工作时间和RSA均低于非手术组。目前的数据表明,对于TLICS评分为4分的胸腰椎骨折患者,可采用手术治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/306f/5944701/706781c9893b/medi-97-e9842-g001.jpg

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