应用后路经椎旁肌间隙入路椎弓根螺钉内固定结合手法复位治疗胸腰椎骨折的疗效观察

Comparing and Observing the Clinical Effect of Posterior Para-spinal Muscle Approach for Internal Fixation of Pedicle Screw Combine with Manipulative Reduction on Fracture of Thoracic and Lumbar Vertebrae

目的对比观察应用后路经椎旁肌间隙入路椎弓根螺钉内固定结合手法复位治疗胸腰椎骨折的临床疗效。方法选取100例患者分成两组,对照组给予传统打开椎弓根入路螺钉内固定的手术方式,试验采用后路经椎旁肌间隙入路椎弓根螺钉内固定结合手法复位的手术方式,对比两组的临床疗效。结果试验组的手术时间,术中出血量,术后引流量均明显少于对照组患者,均有P<0.05,差异有统计学意义。两组的Cobb角矫正率,椎弓根植入准确率等指标没有统计学差别,均有P>0.05。两组患者术前的疼痛VAS评分没有统计学差异,P>0.05;试验组在术后两周,术后1个月,术后6个月的疼痛VAS评分均明显低于对照组,均有P<0.05,差异有统计学意义。结论后路经椎旁肌间隙入路椎弓根螺钉内固定结合手法复位的手术方式与传统打开椎弓根入路螺钉内固定的手术方式有着相同的Cobb角矫正率和椎弓根钉植入准确率,临床疗效值得肯定,同时能够相对传统术式明显缩短手术时间,减少术中出血和术后引流量,术后患者疼痛较轻,是一种值得临床推广的手术方式。

Objective To compare and observe the clinical effect of posterior para -spinal muscle approach for inter-nal fixation of pedicle screw combine with manipulative reduction on fracture of thoracic and lumbar vertebrae .Methods Method：choose 100 patients into two groups , control group given road into the traditional open pedicle screw internal fixation operation method , experiment using the path into the vertebral side clearance road pedicle screw internal fixation combined with manual reduction mode of operation , compared two groups of clinical curative effect.Results The opera-tion time ,amount of bleeding and postoperative drainage volume of the experimental group were significantly less than the control group , both P〈0.05 , the difference was statistically significant.There were no statistically significant difference in two groups′Cobb angle correction rate and the accuracy of pedicle implantation , P〉0.05.Anterior VAS pain score of two groups were not statistically significant , P〉0.05;The operation pain VAS score after operation 2 weeks, 1 months and 6 months in the experimental group were significantly lower than that of the control group ,P〈0.05,the difference was statistically significant.Conclusions Posterior para -spinal muscle approach for internal fixation of pedicle screw combine with manipulative reduction has the same Cobb angle correction rate and accuracy of pedicle screw implantation with traditional open pedicle into the road operation mode of screw ,its clinical efficacy should be affirmed ,and it can can shorten the operation time , reduces the bleeding and postoperative drainage volume comparing with traditional operation way, patients′postoperative pain is light , so it′s an operation mode which is worthy of clinical promotion.