经皮椎弓根螺钉固定治疗无神经损伤胸腰椎骨折效果观察

Effect observation of fixed percutaneous pedicle screws to treat thoracolumbar vertebral fracture without nerve injury

目的探讨微创经皮椎弓根置钉技术治疗无神经损伤的单节胸腰椎骨折临床效果。方法将52例单节无神经损伤的胸腰椎骨折患者随机分为2组,各26例。观察组采用经皮椎弓根置钉术,对照组采用开放椎弓根螺钉内固定术。比较2组手术时间、切口长度、出血量、术后3 d VAS评分,以及2组术前、术后7 d、术后6个月伤椎前缘高度、矢状面Cobb角与Oswestry功能障碍评分。结果观察组手术时间、切口长度、术中出血量、术后3 d VAS评分均显著优于对照组(P<0.05);术前2组伤椎前缘高度比、Cobb角及Oswestry功能障碍评分差异均无统计学意义(P>0.05)。术后7 d、6个月时2组伤椎前缘高度比、Cobb角及Oswestry功能障碍评分均较术前显著改善,组间比较差异均无统计学意义(P>0.05)。结论经皮微创椎弓根螺钉固定治疗单节无神经损伤胸腰椎骨折,手术时间短、创伤小、恢复快,可在掌握手术适应证的前提下广泛应用。

Objective To explore the clinical effect of minimally invasive percutaneous pedicle nailing techniques to treat the single thoracolumbar vertebral fracture without nerve injury. Methods Randomly divided 52 patients with single thoracolumbar vertebral fracture without nerve injury into observation group and control group. The observation group treated with the percutaneous pedicle nailing technique,the control group treated with the open pedicle screw internal fixation. The time of operation,length of incision,amount of bleeding,3d VAS scores after the operation,the anterior height of the fractured vertebra 7 days before and after the operation,6 months after the operation,the Cobb angle of sagittal plane and the Oswestry dysfunction scores in the two groups were compared. Results The time of operation,length of incision,amount of bleeding,3d VAS scores after the operation of the observation group were lower than that of the control group（ P 〈0. 05）,the anterior height of the fractured vertebra,Cobb angle and the Oswestry dysfunction scores before the operation in the two groups had no significant difference（ P 〉0. 05）,the anterior height of the fractured vertebra,Cobb angle and the Oswestry dysfunction scores 7 days and 6 months after the operation had a significant improvement before the operation,the comparison between the groups has no statistical significance（ P〉 0. 05）.Conclusion Minimally invasive percutaneous pedicle screw fixation for the treatment of thoracolumbar fractures with single spinal nerve without injury is of short operation time,small trauma and rapid recovery. It can be widely applied on the premise of mastering the indication of operation.