微创椎弓根钉内固定治疗胸腰段脊柱骨折

Minimally invasive pedicle screw fixation for the treatment of thoracolumbar spine fracture

目的探讨微创椎弓根钉内固定技术治疗胸腰段脊柱骨折的临床效果。方法选择2012年1月至2015年12月在河北省保定市第二医院骨科接受椎弓根内固定术的80例胸腰段脊柱骨折患者为观察对象,根据其手术方式分为微创手术组和开放手术组,每组40例。观察2组患者手术一般情况,比较2组患者手术效果、生活质量和并发症发生率的差异。结果 2组患者手术时间无明显差别;微创手术组术中出血量和术后引流量均小于开放手术组,差异有统计学意义(P<0.05);手术前2组患者椎体前缘压缩度和后凸Cobb’s角无明显差别,术后3个月2组患者的椎体前缘压缩度和后凸Cobb’s角均较手术前降低,且微创手术组降低更明显,与开放手术组比较差异具有统计学意义(P<0.05);手术前2组患者VAS和ODI得分无明显差别,术后3个月,2组患者的VAS和ODI得分均较手术前降低,且微创手术组低于开放手术组,差异有统计学意义(P<0.05);2组患者术后并发症发生率无明显差别;2组患者手术前生活质量无明显差别,术后3个月,2组患者生活质量得分均较手术前增高,且微创手术组增高更明显(P<0.05)。结论微创椎弓根钉内固定术治疗胸腰段脊柱骨折效果好,可明显改善患者的临床症状、体征,提高其生活质量。

Objective To explore the effect of minimally invasive pedicle screw fixation for the treatment of thoracolumbar spine fracture. Methods Totally 80 patients with thoracolumbar spinal fracture accepted pedicle screw internal fixation in our hospital from Janualy 2012 to December 2015 were selected as the observation ohject. According to the operation mode, they were equally divided into minimally invasive surgery group and open surgery group. The operation effect, quality of life and the incidence of complications of the two groups were compared. Results The operation time of the two groups had no significant difference. The amount of blood loss and postoperative drainage volume in minimally invasive surgery group were less than those in open surgery group（ P 〈 0.05 ）. The anterior and posterior Cobb＇ s angles of the two groups had no significant difference. The anterior and posterior Cobb＇ s angles of the two groups both decreased 3 months after oper- ation, and it decreased more significantly in the minimally invasive surgezT group compared with the open surgery group with statistically sig- nificant difference（ P 〈 0.05 ）. The VAS and ODI scores between the two groups had no significant difference before operation. And the scores of the two groups all decreased 3 months after operation, but the reduction in the minimally invasive surgery group was more significant （ P 〈 0.05 ）. The incidence rate of complications of the two groups had no significant difference （ P 〉 0.05 ）. The quality of lite of the two groups had no difference before surgery,and it increased 3 months after the operation both in the two groups,and the minimally invasive surgery group increased more significantly （ P 〈 0.05 ）. Conclusion The minimally invasive pedicle screw internal fixation for thoracolumbar spine fracture has a better therapeutic effect, which can significantly improve the patients clinical symptoms, signs, and their quality of life.