微创椎弓根钉内固定技术对胸腰段脊柱骨折患者的效果分析

Analysis of Effect of Minimally Invasive Pedicle Screw Internal Fixation Technology in Treatment of Patients with Thoracolumbar Spine Fracture

目的探讨和分析在胸腰段脊柱骨折患者的治疗中应用微创椎弓根钉内固定术的效果。方法此次抽取2013年5月—2017年7月在该医院治疗的胸腰段脊柱骨折患者(100例)当做分析对象,遵入院顺序分甲、乙组,每组50例。研究甲组经皮微创椎弓根钉内固定术、乙组开放式椎弓根钉内固定术,对患者的临床相关指标、影像学指标进行总结。结果甲组的切口长度(62.53±2.08)mm、术后引流量(14.11±3.66)mL、术中出血量(94.71±20.56)mL、住院天数(9.41±1.62)d都小于乙组[(119.31±4.57)mm、(168.35±38.55)mL、(287.31±41.74)mL、(15.48±2.38)d],差异有统计学意义(t=79.692、28.165、29.270、14.908,P=0.000)。甲组的手术时间(57.36±20.57)min大于乙组(53.61±19.74)min,但差异无统计学意义(t=0.930,P=0.355)。甲组的椎体前缘高(94.32±9.84)%、椎体矢状面指数(90.71±15.32)%、脊柱后凸角度(4.23±1.02)°都小于乙组[(95.91±11.02)%、(91.78±14.38)%、(4.51±1.09)°],但差异无统计学意义(t=0.761,P=0.448;t=0.360,P=0.720;t=1.326,P=0.188)。结论在胸腰段脊柱骨折患者的治疗中,经皮微创椎弓根钉内固定术在影像学指标的改善上同开放式椎弓根钉内固定术近似,但微创手术的创伤小、术后引流量少、术中出血量少、住院天数短。

Objective To study and analyze the effect of minimally invasive pedicle screw internal fixation technology in treatment of patients with thoracolumbar spine fracture. Methods 100 cases of patients with thoracolumbar spine fracture admitted and treated in our hospital from May 2013 to July 2017 were selected and divided into two groups with 50 cases in each, according to the admission order, the research A group and the research B group were respectively treated with minimally invasive pedicle screw internal fixation surgery and open pedicle screw internal fixation surgery, and the clinical related indicators, and imaging indexes of patients were summarized. Results The incision length, postoperative drainage amount, intraoperative bleeding amount and length of stay in the group A were lower than those in the group B [（62.53 ±2.08）mm,（14.11 ±3.66）mL,（94.71 ±20.56）mL,（9.41 ±1.62）d vs（119.31 ±4.57）mm,（168.35 ±38.55）mL,（287.31 ±41.74）mL,（15.48 ±2.38）d], and the differences were obvious（t =79.692, 28.165, 29.270,14.908, P =0.000）, and the operation time in the group A was bigger than that in the group B [（57.36 ±20.57）min vs（53.61±19.74）min], and the difference was not obvious（t =0.930,P =0.355）, and the anterior margin height of vertebral body, sagittal surface index of vertebral body and kyphosis angle in the group A were lower than those in the group B,[（94.32±9.84）%,（90.71±15.32）%,（4.23±1.02）° vs（95.91±11.02）%,（91.78±14.38）%,（4.51±1.09）°], and the differences were not obvious（t=0.761, P=0.448;t=0.360, P=0.720;t=1.326, P=0.188）. Conclusion The percutaneous minimally invasive pedicle screw internal fixation has a similar effect with the open pedicle screw internal fixation in treatment of patients with thoracolumbar spine fracture, but the wound of minimally invasive surgery is small with less postoperative drainage amount, less intraoperative bleeding amount, and short length of stay.