经皮单节段椎弓根螺钉固定治疗胸腰段骨折的疗效分析

Curative effect analysis of percutaneous monosegmental pedicle screw fixation for thoracolumbar fractures

目的研究经皮单节段椎弓根螺钉固定用于治疗胸腰段骨折的临床疗效。方法将经我院40例确诊的胸腰段骨折的患者,随机分为对照组和实验组两组,每组20例。对照组行常规经后路椎弓根钉固定手术(以下简称短节段术式)。实验组行经皮单节段椎弓根螺钉固定手术(以下简称单节段术式)。对比观察两组在手术前后的影像学效果以及术中的相关情况。结果在经过不同手术方式的治疗后,对照组和实验组的复位疗效相当。术前术后,实验组和对照组在椎体前缘的高度和后凸Cobb’s角以及椎管的受堵方面差异无统计学意义(P>0.05),但术后两组患者椎体前缘的高度和后凸Cobb’s角以及椎管的受堵方面优于术前,差异有统计学意义(P<0.05)。而实验组在切口长度和术中出血量以及手术时间等方面显著优于对照组,差异有统计学意义(P<0.05)。结论使用经皮单节段椎弓根螺钉固定治疗胸腰段骨折,具有创伤小和用时短以及出血少等优点,推荐其为临床上治疗部分创伤性导致的胸腰段骨折术式。

Objective To study the curative effect of percutaneous monosegmental pedicle screw fixation for thoracolumbar fractures. Methods The 40 cases of patients with thoracolumbar fractures were randomly divided into two groups, 20 cases in each group. The control group were treated by routine posterior pedicle screw fixation,while experimental group were treated by percutaneous monosegmental pedicle screw fixation. Compared the imaging effect and intraoperative situation before and after the surgery between the two groups. Results After different surgical method of treatment, control group and experimental group had the similar replacement effect. Before and after treatment, there were no significant statistical differences in anterior vertebral height, Cobb＇ s angle of vertebra rearward protruding and blocking of vertebral canal between the two groups（P 〉 0.05）. But after treatment,the anterior vertebral height, Cobb＇s angle of vertebra rearward protruding and blocking of vertebral canal were better than before treatment （P 〈 0.05）. The length of incision, intraoperative amount of bleeding and time of operation in experimental group were significantly better than that in control group （P 〈 0.05）. Conclusion Percutaneous monosegmental pedicle screw fixation has the advantages of little injury, short time and less bleeding in the treatment of thoracolumbar fractures, and it＇s recommended for the treatment of some traumatic thoracolumbar fractures.