经皮椎弓根螺钉内固定结合伤椎骨水泥强化治疗胸腰椎骨折疗效分析

The curative effect analysis on the treatment of thoracic and lumbar vertebare fractures by the combination of percutaneous pedicle screw fixation and calcium phosphate bone cement

目的探讨经皮椎弓根螺钉内固定结合磷酸钙骨水泥治疗中青年胸腰椎骨折的疗效。方法回顾性分析2014年3月～2016年11月我院收治的72例胸腰椎骨折患者,分为观察组38例和对照组34例,观察组采用经皮椎弓根螺钉内固定结合磷酸钙骨水泥强化,对照组采用后路切开椎弓根螺钉撑开复位内固定、伤椎椎体植骨。记录两组手术时间、手术出血量、住院时间;测量术前和术后伤椎体前、后缘高度比和后凸Cobb角;记录两组患者术前和术后VAS评分。结果与对照组相比较,观察组术前及术后3个月内的VAS评分、手术出血量、住院时间方面差异均有统计学意义(P<0.05);两组患者在手术时间、术前和术后伤椎椎体前后缘高度百分比、伤椎椎体后凸Cobb角、内固定取出前VAS评分方面差异均无统计学意义(P>0.05)。结论经皮椎弓根螺钉内固定结合磷酸钙骨水泥治疗中青年胸腰椎骨折疗效可靠,能有效减轻手术应激,符合快速康复(ERAS)理念的核心原则。

Objective To explore the clinical effect of percutaneous pedicle screw fixation combined with calcium phosphate bone cement for the treatment of thoracic and lumbar vertebare fractures.Methods 72 patients with thoracic and lumbar vertebare fracture from Mar 2014 to Nov 2016 were retrospectively analyzed,and divided into observation group(38 cases)and control group(34 cases).The observation group was treated by percutaneous pedicle screw fixation combined with calcium phosphate bone cement.The control group was treated by posterior pedicle screw distraction and internal fixation,and bone graft of injured vertebra.The operation time,introoperative bleeding volume and length of stay were recorded.Anterior and posterior wertebral height and kyphosis Cobb angle were measured and VAS score was recorded in both groups before and after operation.Results There were significant differences in VAS score,bleeding volume and length of stay between the two groups(P<0.05).There was no significant difference between the two groups in operative time,percentage of anterior and posterior vertebral height,Cobb angle of kyphosis and VAS score after operation(P>0.05).Conclusion Percutaneous pedicle screw fixation combined with calcium phosphate bone cement is an effective and reliable treatment for thoracic and lumbar vertebare fractures in young and middle-aged patients.It can effectively relieve the stress of operation and accords with the core principle of rapid recovery(ERAS).