经皮椎弓根螺钉内固定选择性治疗胸腰椎骨折的效果观察

Clinical observation of per cutem pedicle of vertebral arch screw internal fixation in the treatment of fracture of thoracic and lumbar vertebrae

目的探讨经皮椎弓根螺钉内固定选择性治疗胸腰椎骨折的临床效果。方法选取2013年1月至2014年6月本院收治的62例胸腰椎骨折患者为研究对象,采用随机数表法将其分为对照组和试验组,每组各31例。试验组患者行经皮椎弓根螺钉内固定选择性治疗,对照组患者采取传统后路切开复位椎弓根螺钉内固定治疗。比较两组患者的围术期及影像学指标。结果两组患者手术时间比较差异无显著性(P>0.05);试验组患者住院时间、带支具下床时间、术中出血量、术后引流量均明显低于对照组(P<0.05);两组患者术后Cobb角、伤椎前缘高度、矢状位指数比较无显著差异(P>0.05),但手术前后上述指标比较均具有显著差异(P<0.05)。结论经皮椎弓根螺钉内固定选择性治疗胸腰椎骨折具有明显的临床效果,并且具有创伤小、恢复快等优势,值得临床推广。

Objective To investigate the effect of per cutem pedicle of vertebral arch screw internal fixation in the treatment of fracture of thoracic and lumbar vertebrae. Method Selected 62 patients with fracture of thoracic and lumbar vertebrae from January 2013 to June 2014 treated in our hospital as research objects, according to the random number table method, they were randomly divided into control group and experimental group, 31 cases in each group. Patients in experimental group were treated with per cutem pedicle of vertebral arch screw internal fixation, and patients in control group were treated with traditional posterior approach and the pedicle of vertebral arch screw internal fixation, perioperative period and iconography indicators were compared between the two groups. Result There was no significant difference in operation time between the two groups（P〈0.05）; the length of stay, the time of getting out of bed with orthosis, the amount of bleeding during operation, and the amount of drainage in experimental group were significantly lower than control group（P〈0.05）. There was no significant difference between the two groups in the Cobb angle, height of injured vertebra and sagittal index（P〈0.05）, but before and after the operation of the above indicators were significantly different（P〈0.05）. Conclusion Ppedicle of vertebral arch screw internal fixation in the treatment of fracture of thoracic and lumbar vertebrae has obvious curative effect, and has the advantages of small trauma, quick recovery, it is worthy of clinical promotion.