结合术式对老年胸腰段脊椎骨折患者的疗效观察及临床分析

Clinical observation and analysis of combined operation for elderly patients with thoracolumbar spine fracture

目的:探究老年胸腰段脊椎骨折患者行后路椎弓根内固定结合椎体成形术的疗效。方法:将85例经本院治疗的胸腰段脊椎骨折老年患者按术式分组,对照组43例患者行单纯后路经椎弓根内固定术治疗,观察组42例患者行后路椎弓根内固定结合椎体成形术治疗。对比两组患者手术疗效及相关指标情况。结果:两组患者术后半年及2年时,VAS评分、脊柱后突Cobb’s角、椎体前缘及后缘的高度压缩率数值较术前均显著下降,且观察组数值下降较对照组更明显,差异均具有统计学意义(P<0.05);观察组患者手术优良率80.95%显著高于对照组的58.14%(χ~2=5.208,P=0.023);且术后随访发现,观察组术后内固定松动断裂发生率4.76%显著低于对照组的23.25%(χ~2=5.994,P=0.014)。结论:老年胸腰段脊椎骨折行后路椎弓根内固定结合椎体成形术,手术优良率高且降低了内固定失败率,能恢复伤椎完整形态及生物力学强度,有效改善老年患者生活,建议广泛应用。

Objective:To explore the clinical effect of posterior pedicle screw fixation combined with vertebroplasty in the elder-ly patients with thoracolumbar spine fracture.Methods:Based on different operation,85cases of elderly patients in our hospital after treatment of thoracolumbar spine fracture were divided into observation group and control group,43cases of the patients in the control group were treated with simple posterior pedicle screw fixation,42cases of the patients in the observation group were given posterior pedicle screw fixation combined with vertebroplasty.The curative effect and relative index were compared in the two groups.Results:Af-ter the operation6months and2years,VAS score,spinal kyphosis Cobb,s angle,vertebral height compression rate and posterior verte-bral height compression rate significantly decreased in the patients of two groups,and these in the observation group decreased more sig-nificantly than those in the control group,the difference was statistically significant(P<0.05).The excellent operation rate of80.95%in the observation group was significantly higher than that of58.14%in the control group(^2=5.208,P=0.023).By postoperative follow-up,it found that the internal fixation loosening fracture rate of4.76%in the observation group was significantly less than that in the the control group23.25%(^2=5.994,P=0.014).Conclusion:The posterior pedicle screw fixation combined with vertebro-plasty in the elderly patients with thoracolumbar spine fracture has significant effect,high curative rate and reduce the failure rate of in-ternal fixation,can restore the vertebral intact morphology and biomechanical strength,effectively improve the quality of life of elderly patients,be worthy of clinical promotion.