脊柱改良型外固定器治疗胸腰椎骨折的疗效观察

Clinical observation of modified external fixator for the treatment of thoracolumbar fractures

目的:观察胸腰椎骨折中椎弓根螺钉钉棒系统内固定与脊柱改良型外固定器的临床疗效。方法:外固定组使用改良外固定器联合体外复位联合微创技术治疗,内固定组使用传统钉棒系统进行切开复位内固定,每组患者各50例。比较两组患者手术时间、出血量、住院时间、术前、术后、末次随访伤椎前缘高度比及脊柱后突Cobb角及患者术后满意度。结果:外固定器手术组在手术时间、术中出血量、住院时间上明显少于内固定钉棒组(P<0.05),差异具有统计学意义。所有患者伤椎高度在术后、末次随访结果与术前相比均有明显改善(P<0.05)。两组患者伤椎术后及末次随访结果及后突Cobb角对比均无明显差异,二者治疗水平相当,差异不具有统计学意义(P>0.05)。患者术后主观满意度相当。结论:改良型外固定器微创治疗脊柱胸腰椎骨折中具有与切开复位钉棒内固定相同的治疗效果,但其手术时间更短、术中出血少、操作简便、患者住院时间短,是一种治疗胸腰椎骨折的有效微创治疗手段,值得临床推广。

Objective：Comparison of pedicle screw rod system fixation and modified external fixator in the treatment of thoracolumbar fractures. Method：The treatment group used improved external fixation of external fixator combined with in vitro reduction combined with minimally invasive technique, internal fixation group using traditional screw rod system for open reduction and internal fixation, 50 cases of patients in each, comparing the operation time, amount of bleeding, hospitalization time, preoperative and postoperative follow-up, anterior vertebral height ratio, kyphosis Cobb angle and Postoperative patient satisfaction.Result：The operation time, intraoperative blood loss, length of stay in the external fixator group were significantly less than that in the internal fixation group, the difference was statistically significant. The height of the injured vertebrae in all patients was significantly improved after operation and the last follow-up, the difference was statistically significant. There was no significant difference between the two groups in the postoperative and follow-up results of the injured vertebral body and the follow-up Cobb angle, the treatment level of the two groups was the same, the difference was not statistically significant. The difference of subjective satisfaction has no statistical significance. Conclusion：The modified minimally invasive external fixation in the treatment of thoracic and lumbar spinal fractures with open reduction and screw fixation effect of the same treatment, but the shorter operation time, less bleeding, simple operation, short hospitalization time, is an effective and minimally invasive treatment of thoracolumbar fractures in the treatment period, it is worthy of clinical promotion.