经皮经伤椎椎弓根置钉内固定术对单节段胸腰椎骨折患者伤椎高度、Cobb角的影响

The Effect of Percutaneous Pedicle Screw Fixation on Vertebral Height and Cobb Angle in pPatients with Single Segment Thoracolumbar Fractures

目的探讨经皮经伤椎椎弓根置钉内固定术在单节段胸腰椎骨折患者中的疗效.方法选择2020年4月—2022年5月我院收治的76例胸腰椎骨折患者为研究对象,按随机数字表法分为对照组与观察组.对照组(n=38)采用开放椎弓根螺钉内固定术治疗,观察组(n=38)采用经皮经伤椎椎弓根置钉内固定术治疗,两组均持续随访3个月.对比两组患者伤椎高度、Cobb角、围术期指标及腰椎功能.结果术前及术后3个月,两组伤椎前缘高度比、Cobb角水平相比,组间差异无统计学意义(P>0.05).术后3个月,与同组术前相比,两组伤椎前缘高度比均高于术前,伤椎Cobb角均小于术前,差异有统计学意义(P<0.05).观察组的手术时间为(102.51±11.22)min,长于对照组的(87.76±10.26)min,术中出血量为(71.64±28.26)mL,少于对照组的(71.64±28.26)mL,术后住院时间为(8.68±2.14)d,短于对照组的(13.15±2.26)d,组间差异有统计学意义(P<0.05).两组术前、术后3个月,Oswestry功能障碍指数问卷表评分相比,组间差异无统计学意义(P>0.05).与同组术前相比,两组术后3个月腰椎功能评分均降低,差异有统计学意义(P<0.05).结论针对单节段胸腰椎骨折患者实施经皮经伤椎椎弓根置钉内固定术治疗,能够减少术中出血,缩短术后恢复时间,改善其伤椎高度、Cobb角,促进腰椎功能恢复.

Objective To explore the efficacy of percutaneous pedicle screw fixation for single segment thoracolumbar fractures.Methods 76 patients with thoracolumbar fracture admitted to our hospital from April 2020 to May 2022 were selected as the study objects,and were divided into control group and observation group according to random number table method.The control group(n=38)was treated with open pedicle screw internal fixation,and the observation group(n=38)was treated with percutaneous pedicle screw internal fixation.Both groups were followed up for 3 months.The injured vertebral height,Cobb Angle,perioperative indexes and lumbar function were compared between the two groups.Results Before surgery and 3 months after surgery,there was no significant difference in the ratio of anterior vertebra height and the level of Cobb Angle between the two groups(P>0.05).Three months after surgery,the ratio of anterior edge height of injured vertebrae in both groups was higher than before surgery,and the Cobb Angle of injured vertebrae was lower than before surgery,with statistical significance(P<0.05).The operative time of the observation group was(102.51±11.22)min,which was longer than(87.76±10.26)min of the control group,the intraoperative blood loss was(71.64±28.26)mL,which was less than(71.64±28.26)mL of the control group,the postoperative hospitalization time was(8.68±2.14)d,it was shorter than(13.15±2.26)d of the control group,and the differences between groups were statistically significant(P<0.05).There was no significant difference in the score of Oswestry Disability Index between the two groups before and 3 months after surgery(P>0.05).Compared with the same group before surgery,the lumbar function scores of both groups were lower 3 months after surgery,and the difference was statistically significant(P<0.05).Conclusion The implementation of percutaneous pedicle screw fixation for single segment thoracolumbar fractures can reduce intraoperative bleeding,shorten postoperative recovery time,improve the height and Cobb angle of the injured vertebra,and promote the recovery of lumbar function.