微创短节段经皮椎弓根螺钉结合经椎弓根注入可注射硫酸钙治疗胸腰椎骨折

Minimally invasive percutaneous pedicle screws combined with injectable calcium sulfate in treatment of thoracic and lumbar fractures

[目的]探讨胸腰段椎体骨折患者采用微创短节段经皮椎弓根螺钉联合伤椎内经椎弓根注入硫酸钙治疗的临床疗效。[方法]回顾性分析61例胸腰椎骨折患者的临床资料,根据手术方法分为观察组32例和对照组29例,观察组采用微创短节段经皮椎弓根螺钉联合伤椎内经椎弓根注入硫酸钙治疗,对照组仅采用微创短节段经皮椎弓根螺钉固定治疗。[结果]观察组的手术时间、术中出血量显著高于对照组且差异均具有统计学意义(P<0.05);观察组住院时间、术后下地时间均显著短于对照组且差异均具有统计学意义(P<0.05)。观察组、对照组患者术后不同时间的VAS评分、Cobb角、椎体前缘高度压缩率、椎体后缘高度压缩率较术前均显著降低(P<0.05);术后1周、末次随访观察组患者的上述指标均显著低于同期对照组患者(P<0.05)。观察组的Frank分级分布显著优于对照组(Z=-2.552,P=0.011)。[结论]胸腰段椎体骨折患者采用微创短节段经皮椎弓根螺钉联合伤椎内经椎弓根注入硫酸钙治疗能够缩短恢复时间,增加椎体高度稳定性,减少Cobb角丢失。

[Objective]To investigate the clinical curative effect of short segment percutaneous pedicle screws combined with injectable calcium sulfate for the minimally invasive treatment of thoracolumbar vertebral fractures. [Method]A retrospective analysis of the clinical data of 61 cases of thoracolumbar fractures was made in this study. According to the treatment methods,patients were divided into the observation group（ n = 32 cases） and control group（ n = 29 cases）. Patients in the observation group were treated with minimally invasive percutaneous short segmental pedicle screw fixation combined with vertebral pedicle screw in the injectable calcium sulfate treatment,while patients in the control group only with minimally invasive percutaneous short segmental pedicle screw fixation. Curative effects were observed and compared between two groups to find out whether this combined surgery method was effective. [Result]The operation time,bleeding volume in observation group were significantly higher than those in the control group and the difference was statistically significant（ P〈0. 05）. The hospitalization time,postoperative off- bed time in the obsevaton group were significantly shorter than those in the control group and the difference was statistically significant（ P〈0. 05）. Bolth in the observation group and the control group,postoperative VAS score,Cobb angle,anterior vertebral height ratio,vertebral height compression rate at different time points were significantly lower than those before operation（ P〈0. 05）,At one week after surgery and at the last follow- up,however,above indexed were all lower in the observation group than those in the control group（ P〈0. 05）. Furthermore,Frank grade distribution in the observation group was significantly better than that of the control group（ Z =- 2. 552,P = 0. 011）. [Conclusion]Minimally invasive percutaneous short segmental pedicle screw fixation combined with injectable calcium sulfate is effective. It can shorten the recovery time,improve the vertebrae height stability and reduce the loss of Cobb angle.