伤椎置钉和经皮短节段固定治疗胸腰段椎体骨折的疗效比较

A clinical comparative analysis of the treatment between open short-segment pedicle screw fixation and percutaneous short-segment pedicle screw fixation for thoracolumbar fractures

目的对比开放伤椎置钉和经皮微创短节段固定治疗胸腰段椎体骨折的近期临床疗效。方法回顾性分析35例胸腰段椎体骨折患者,分为开放伤椎置钉短节段固定组(A组)和经皮微创短节段固定组(B组),测量手术前后骨折椎体压缩程度,椎体后凸畸形角度,疼痛视觉模拟评分(VAS)以及术后腰椎功能障碍指数(ODI),统计两组患者住院时间,手术失血和手术时间,并对以上参数进行对比分析。结果两组患者一般资料,术前骨折椎体压缩程度和VAS评分差异无统计学意义(P>0.05)。两组患者术后骨折椎体高度均有效恢复(P<0.05),且良好维持,术后VAS和ODI评分均较术前改善(P<0.05),且B组术后ODI评分优于A组。B组在手术时间,失血量和住院时间上较A组缩短。结论两种手术方式均能有效恢复骨折椎体高度,改善术后功能,但经皮微创短节段固定在手术时间,失血量,住院时间和功能上要优于伤椎置钉短节段固定组。

Objective To comparatively analyze the clinical efficacies of the treatment between open short-segment pedicle screw fixa-tion including the fractured vertebra and percutaneous short-segment pedicle screw fixation for thoracolumbar fractures.Methods A retrospective analysis was made of 35 cases of thoracolumbar fractures which were assigned into open short-segment pedicle screw fixa-tion including the fractured vertebra（group A）and minimally invasive percutaneous short-segment pedicle screw fixation group（group B）.The compression percentage of the fractured vertebra,vertebral kyphosis angle,visual analogue scale（VAS）of back pain and Oswe-stry Disability Index（ODI）were measured before and after surgery.Hospitalized time,blood loss and surgical time were also compara-tively analyzed between the two groups.Results The demographic data,compression percentage of vertebral fractures and VAS were not significantly different between the two groups before operation（P 〉0.05）.All patients’vertebral height were effectively restored, and well maintained postoperatively.Postoperative VAS and ODI scores improved significantly than preoperation（P 〈0.05）,and post-operative ODI score in group B was higher than that in group A.Hospitalized time,blood loss and surgical time in group B were shorter （P 〈0.05）.Conclusions Both the two operations can effectively restore vertebral height,improve postoperative function,but percuta-neous short-segment pedicle screw fixation takes the advantages of shortened hospitalized time,less blood loss,reduced surgical time and functional superiority.