Sextant微创经皮椎弓根螺钉内固定手术治疗中老年脊柱骨折患者的疗效及对患者生存质量的影响

Sextant minimally invasive percutaneous pedicle screw fixation for the treatment of middle-aged and elderly spine fractures and its effect on patients' quality of life

目的研究分析Sextant微创经皮椎弓根螺钉内固定手术治疗中老年脊柱骨折的疗效及对患者生存质量的影响,为临床治疗提供参考。方法选取2012年3月至2017年3月期间在本院接受诊治的86例中老年胸腰椎段脊柱骨折患者作为研究对象,根据随机数表法分为对照组41例、研究组45例。对照组患者实施开放式椎弓根螺钉内固定术治疗,研究组患者接受Sextant微创经皮椎弓根螺钉内固定术治疗。比较两组手术指标、影像学指标及生存质量情况。结果两组患者的手术时间差异无统计学意义;研究组患者术中出血量、术后住院时间均低于对照组,差异有统计学意义(P<0.05);两组患者术后椎体矢状面指数、椎体前缘高度均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后两组患者的Cobb′s角均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后研究组患者生理职能、情感职能、躯体疼痛、社会功能、总体健康评分均高于对照组,差异有统计学意义(P<0.05)。结论 Sextant微创经皮椎弓根螺钉内固定手术治疗中老年脊柱骨折效果显著,能有效减轻机体损伤,改善患者的脊柱后凸角度及椎体高度,促进患者身体恢复,提高患者生存质量,值得临床推广。

Objective To study the effect of Sextant minimally invasive percutaneous pedicle screw internal fixation in the treatment of middleaged and elderly patients with spinal fractures and quality of life of patients,provide a reference for clinical treatment.Methods 86 cases of elderly patients with thoracolumbar spine fractures treated in our hospital from March 2012 to March 2017 were selected as the subjects of this study.According to random number table,all patients were divided into control group(n=41)and study group(n=45).The patients in the control group were treated with open pedicle screw internal fixation,and the patients in the study group were treated with Sextant minimally invasive percutaneous pedicle screw internal fixation.The operation indexes,imaging indexes and quality of life of the two groups were compared between the two groups.Results There was no significant difference in operative time between the two groups.The bleeding volume and postoperative hospital stay in study group were lower than those in control group,with significant difference(P<0.05).The sagittal index of vertebral body and the height of the anterior vertebral body in the two groups were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).The postoperative Cobb's angle of the two groups were lower than preoperative,and the study group was lower than the control group,the difference was statistically significant(P<0.05);The postoperative study group had higher physical function,emotional function,somatic pain,social function and overall health score than the control group(P<0.05).Conclusion Sextant minimally invasive percutaneous pedicle screw fixation for the treatment of middle-aged and elderly spine fracture effect is significant,can effectively reduce the body injury,improve the patient's kyphosis angle and vertebral height,promote patient recovery and improve patient quality of life,it is worth clinical Promotion.