经皮与开放椎弓根螺钉内固定术治疗无神经损伤胸腰段骨折的疗效对比

Comparison of Curative Effect of Percutaneous and Open Pedicle Screw Fixation in Treatment of Thoracolumbar Fracture without Nerve Injury

目的探究经皮椎弓根螺钉内固定术和经皮椎弓根螺钉内固定术治疗无神经损伤胸腰段骨折的临床疗效。方法选取2015年7月—2016年3月间该院收治的60例无神经损伤胸腰段骨折患者,根据治疗方式的不同分为经皮组30例与开放组30例,观察比较两组的手术时间,术中出血量、住院天数及并发症发生率等手术情况。随访12个月后,比较两组患者末次随访时Cobb角丢失值。结果经皮组手术时间(45.36±2.63)min,术中出血量(57.62±22.68)m L,住院天数(5.96±0.85)d,术后恢复时间(13.95±6.56)d,均优于开放组的(87.73±6.32)min,(153.96±26.84)m L、(7.32±1.57)d、(31.19±6.74)d,但是经皮组的住院费用(5.16±0.96)万元高于开放组的(3.45±1.13)万元,两组比较差异有统计学意义(P<0.05)。经皮组出现一例术后并发症,开放组出现2例术后并发症,两组比较差异无统计学意义(P>0.05)。随访12个月后,经皮组Cobb角丢失(7.62±1.78)°,开放组Cobb角丢失(7.89±2.03)°,两组比较差异无统计学意义(P>0.05)。结论经皮椎弓根螺钉内固定术和开放椎弓根螺钉内固定术都能良好的治疗无神经损伤胸腰段骨折患者,但是经皮椎弓根螺钉内固定术可以在更短时间内完成手术,更有利于患者的术后恢复,然而手术费用高于开放椎弓根螺钉内固定术。

Objective To study the curative effect of percutaneous and open pedicle screw fixation in treatment of tho-racolumbar fracture without nerve injury. Methods 60 cases of patients with thoracolumbar fracture without nerve in-jury admitted and treated in our hospital from July 2015 to March 2016 were selected and divided into two groups with 30 cases in each according to treatment method, and the operation time, intraoperative bleeding amount, length of stay and incidence rate of complications were compared between the two groups, after 12-month follow-up, the Cobb value loss value at the last follow -up was compared between the two groups. Results The operative time, intraoperative bleeding amount, length of stay and postoperative recovery time were better than those in the open group[（45.36±2.63）min, （57.62±22.68）mL, （5.96±0.85）d, （13.95±6.56）d vs （87.73±6.32）min,（153.96±26.84）mL,（7.32±1.57）d,（31.19±6.74）d], and the hospitalization cost was higher than that in the open group[（5.16±0.96）tenthousand yuan vs （3.45±1.13）tent- housand yuan], and the difference between the two groups was statistically significant（ P〉0.05）, after 12-month follow- up, the difference in the Cobb angle loss between the percutaneous group and open group was not statistically signifi-cant, [（7.62±1.78）毅 vs （7.89±2.03）0]（P〉0.05）. Conclusion The percutaneous and open pedicle screw fixation can bet-ter treat the patients with Thoracolumbar fracture without nerve injury, but the former can complete the operation in a short time, which is more conducive to the postoperative recovery, but the operation expenses are higher than those of open pedicle screw fixation.