经皮微创与开放式椎弓根螺钉内固定术治疗胸腰椎段脊柱骨折的疗效对比

Comparison between percutaneous pedicle screw fixation and open pedicle screw fixation in treatment of thoracic and lumbar spine fracture

目的研究并探讨经皮微创椎弓根螺钉内固定术与开放式椎弓根螺钉内固定术治疗胸腰椎段脊柱骨折的临床疗效。方法选取本院在2013年1月至2016年10月收治的95例胸腰椎段脊柱骨折患者作为研究对象,根据手术方式分为对照组、观察组,对照组实施开放式椎弓根螺钉内固定术,观察组实施经皮微创椎弓根螺钉内固定术。比较两组患者的手术时间、术中出血量、住院时间、并发症发生率、伤椎前后缘高度比、后凸角度。结果两组患者的手术时间比较,差异无统计学意义(P>0.05),但观察组的术中出血量、住院时间较对照组相对更少(P<0.05);观察组患者的并发症发生率较对照组更低(P<0.05);手术后,两组患者的伤椎前缘高度比、伤椎后缘高度比、后凸角度均明显改善(P<0.05),术后两组比较差异无统计学意义(P>0.05)。结论胸腰椎段脊柱骨折患者实施经皮微创椎弓根螺钉内固定术治疗,其对患者椎体高度、脊柱后凸角度的改善效果与开放式椎弓根螺钉内固定术相当,且具有术中出血量少、并发症少、术后恢复快等优点。

Objective To study the clinical effect of percutaneous pedicle screw fixation and open pedicle screw fixation in the treatment of thoracolumbar vertebral fractures. Methods In our hospital,95 cases of thoracolumbar spine fractures treated in our hospital from January 2013 to October 2016 were selected as the research objects,the patients were divided into control group and observation group,control group to implement the open pedicle screw fixation,the observation group received minimally invasive percutaneous pedicle screw fixation. The operation time,blood loss,length of stay,incidence of complications,the height of the anterior and posterior margin of the vertebral body, and the posterior convex angle of the two groups were compared.Results The two groups were compared operative time,there was no statistically significant difference（ P〈0.05）,but the amount of bleeding,hospitalization time in observation group were less than those in the control group（ P〈0.05）; patients with complication rate lower than the control group（ P〈0.05）; after the surgery,two patients with anterior vertebral height height ratio,vertebral rear ratio and kyphosis angle were significantly improved（ P〈0.05）,after two were not statistically significant（ P〉0. 05）. Conclusions Thoracolumbar spine fractures are treated with minimally invasive percutaneous pedicle screw fixation in the treatment of patients,the vertebral height,kyphosis angle effect and open pedicle screw fixation,which has the advantages of less bleeding,fewer complications,faster recovery etc.