后路椎弓根螺钉固定术联合融合治疗对屈曲牵张性损伤的疗效

Effect of posterior pedicle screw fixation combined with fusion therapy on flexion stretch injury

目的探讨后路椎弓根螺钉固定术联合融合治疗对屈曲牵张性损伤的临床疗效。方法选择无神经功能障碍的屈曲牵张性损伤患者60例进行回顾性分析,按手术方式将患者分为观察组(经皮后路椎弓根螺钉固定术联合融合治疗)和对照组(开放手术联合融合治疗),各30例。比较两组的治疗效果。结果观察组的术中出血量、住院时间、术后第2天及术后1月的VAS评分均优于对照组(P<0.05)。术后,两组后凸Cobb角均减小,伤椎前缘高度均升高(P<0.05),但两组之间无显著差异(P>0.05)。两组的手术时间、出院前损伤节段中柱高度、术后并发症总发生率均无显著差异(P>0.05)。术后随访1年,两组患者骨折均愈合,且位置固定良好,未出现内固定失败。结论后路椎弓根螺钉固定术联合融合治疗屈曲牵张性损伤患者具有术中出血少、术后疼痛轻、住院时间短的优势,临床疗效确切,且安全性高,值得推广。

Objective To investigate the clinical effect of posterior pedicle screw fixation combined with fusion therapy on flexion stretch injury.Methods Sixty patients with flexion stretch injury without neurological dysfunction were retrospectively selected for retrospective analysis and the patients were divided into observation group(posterior pedicle screw fixation combined with fusion therapy)and control group(open surgery combined with fusion therapy),with 30 cases in each group.The therapeutic effects of the two groups were compared.Results The amount of intraoperative blood loss,hospitalization time and the VAS scores at postoperative 2 days and 1 month in the observation group were better than those in the control group(P<0.05).After operation,the Cobb angle of kyphosis decreased and the anterior height of injured vertebrae increased in both groups(P<0.05),but there were no significant differences between the two groups(P>0.05).There were no significant differences in the operation time,height of the injured segment before discharge and total incidence of complications between the two groups(P>0.05).All patients were followed up for 1 year,and all fractures of patients healed with good fixation and no failure of internal fixation.Conclusion Posterior pedicle screw fixation combined with fusion therapy on patients with flexion stretch injury has the advantages of less bleeding during operation,less pain after operation and shorter hospitalization time.It has a definite clinical effect and high safety.It is worth popularizing.