经椎弓根植骨椎体成形结合椎弓根钉固定治疗胸腰椎骨折远期疗效分析

Analysis of long-term curative effect by transpedicular bone grafting vertebroplasty combined with pedicle screw fixation in the treatment of thoracolumbar vertebral fracture

目的分析经椎弓根植骨椎体成形结合椎弓根钉固定治疗胸腰椎骨折远期疗效。方法 50例胸腰椎骨折患者,均采用经椎弓根植骨椎体成形结合椎弓根钉固定治疗。比较患者治疗前后的前臂高度压缩率、后壁高度压缩率、Cobb角度、疼痛情况。观察手术治疗效果。结果 50例患者治疗后,25例患者治疗效果为优,占50%,18例患者治疗效果为良,占36%,5例患者治疗效果为可,占10%,2例患者治疗效果为差,占4%,治疗优良率为86%。患者治疗前后的前臂高度压缩率、后壁高度压缩率、Cobb角度比较差异均具有统计学意义(P<0.05)。患者治疗后视觉模拟评分法(VAS)评分为(1.4±1.0)分,低于治疗前的(7.8±1.8)分,差异具有统计学意义(t=21.9776,P<0.05)。结论胸腰椎骨折患者经椎弓根植骨椎体成形结合椎弓根钉固定治疗后远期临床效果显著,可有效缓解患者的疼痛,将其相关指标进行改善,临床应用价值存在。

Objective To analyze long-term curative effect by transpedicular bone grafting vertebroplasty combined with pedicle screw fixation in the treatment of thoracolumbar vertebral fracture. Methods A total of 50 patients with thoracolumbar vertebral fracture all received transpedicular bone grafting vertebroplasty combined with pedicle screw fixation for treatment. Comparison was made on compression ratio of forearm height, compression ratio of paries posterior, Cobb angle, and pain condition before and after treatment between the two groups. Observation was made on curative effects by surgery in the two groups. Results After treatment for the 50 patients, there were 25 cases with excellent curative effect, accounting for 50%, 18 cases with good curative effect, accounting for 36%, 5 cases with moderate curative effect, accounting for 10%, and 2 cases with poor curative effect, accounting for 4%. Their good rate of treatment was 86%. The differences of compression ratio of forearm height, compression ratio of paries posterior, and Cobb angle before and after treatment all had statistical significance（P〈0.05）. The patients had lower visual analogue scale（VAS） score after treatment as（1.4±1.0） points than（7.8±1.8） points before treatment, and their difference had statistical significance（t=21.9776, P〈0.05）. Conclusion Combination of transpedicular bone grafting vertebroplasty and pedicle screw fixation shows excellent long-term clinical effect. This method can effectively relieve pain in patients and improve their related indexes, and it contains value for clinical application.