微创经皮并结合伤椎椎弓根螺钉固定治疗胸腰椎骨折的效果体会

Experience of effect by minimally invasive percutaneous combined with injured vertebrae pedicle screw fixation in the treatment of thoracolumbar vertebral fracture

目的探究对胸腰椎骨折患者行以微创经皮并结合伤椎椎弓根螺钉固定治疗的临床效果。方法 102例胸腰椎骨折患者,按照入院时间将其分为常规组与研究组,每组51例。常规组患者行开放椎弓根螺钉内固定治疗,研究组患者行微创经皮并结合伤椎椎弓根螺钉固定治疗,对两组患者的围手术指标和影像学指标进行分析和比较。结果治疗后,研究组术中出血量为(83.3±65.3)ml,切口长度为(9.1±1.3)cm,手术时间为(112.1±20.5)min,术后引流量为(5.3±4.3)ml,疼痛评分为(2.3±1.3)分,住院时间为(9.2±2.5)d,对照组上述指标分别为(369.4±65.3)ml、(15.5±2.2)cm、(143.8±22.2)min、(220.6±66.5)ml、(4.4±2.3)分、(14.3±2.8)d,研究组患者围手术指标均明显优于常规组(P<0.05)。手术前后两组患者的影像学各项指标比较差异均无统计学意义(P>0.05)。结论对胸腰椎骨折患者行以微创经皮并结合伤椎椎弓根螺钉固定治疗效果更加确切,具有一定的临床价值。

Objective To investigate clinical effect by minimally invasive pereutaneous combined with injured vertebrae pedicle screw fixation in the treatment of thoracolumbar vertebral fracture patients. Methods A total of 102 patients with thoracolumbar vertebral fracture were divided by admission order into conventional group and research group, with 51 cases in each group. The conventional group received open pedicle screw internal fixation for treatment, and the research group received minimally invasive percutaneous combined with injured vertebrae pediele screw fixation for treatment. Analysis and comparison were made on perioperative and imaging indexes between the two groups. Results After treatment, the research group had intraoperative bleeding volume as （83.3 ± 65.3） ml, incision length as （9.1 ± 1.3） cm, operation time as （112.1 ± 20.5） min, postoperative drainage volume as （5.3 ± 4.3） ml, pain score as （2.3 ± 1.3） points, and hospital stay time as （9.2 ± 2.5） d, which were respectively （369.4 ± 65.3） ml, （15.5 ± 2.2） cm, （143.8 ± 22.2） min, （220.6 ± 66.5） ml, （4.4 ± 2.3） points and （14.3 ± 2.8） d in the conventional group. The research group had obviously better perioperative indexes than the conventional group （P〈0.05）. There was no statistically significant difference of imaging indexes between the two groups before and after operation （P〉0.05）. Conclusion Implement of minimally invasive percutaneous combined with injured vertebrae pedicle screw fixation provides precisely curative effect in the treatment of thoracolumbar vertebral fracture patients, and this method contains certain clinical value.