微创椎弓根钉内固定术治疗胸腰椎创伤性骨折的效果观察

Effect of minimally invasive pedicle screw fixation for treatment of traumatic fracture of the thoracolumbar spine

目的:研究用微创椎弓根钉内固定术治疗胸腰椎创伤性骨折的效果。方法:选择四川友谊医院2017年4月至2018年4月收治80例胸腰椎创伤性骨折患者作为研究对象。按照手术方式的不同将其分为观察组(40例)和对照组(40例)。为对照组患者采用开放式椎弓根钉内固定术进行治疗,为观察组患者采用微创椎弓根钉内固定术进行治疗。然后比较两组患者的各项手术指标和术后恢复情况。结果:1)在术后1周,两组患者伤椎椎体前缘高度的百分比、伤椎椎间隙的高度均较术前明显提高,其Cobb角均较术前明显减小,P <0.05;两组患者伤椎椎体前缘高度的百分比、伤椎椎间隙的高度和Cobb角相比,P>0.05。2)观察组患者术中的出血量少于对照组患者,其切口的长度、术中剥离骶棘肌的长度和术后住院的时间均短于对照组患者,P <0.05。3)在术后1个月,两组患者的JOA评分均较术前明显提高,P <0.05;观察组患者的JOA评分高于对照组患者,P <0.05。结论:用微创椎弓根钉内固定术治疗胸腰椎创伤性骨折具有疗效确切、创伤小、患者术中的出血量少、术后恢复快等优点。

Objective:To investigate the effect of minimally invasive pedicle screw fixation in the treatment of thoracolumbar traumatic fractures.Methods:80 patients with thoracolumbar traumatic fractures admitted to sichuan friendship hospital from April 2017 to April 2018 were selected as the study subjects.The patients were divided into observation group(40 cases)and control group(40 cases)according to different surgical methods.Patients in the control group were treated with open pedicle screw fixation,and patients in the observation group were treated with minimally invasive pedicle screw fixation.Then the surgical indexes and postoperative recovery of the two groups were compared.Results:1)1 week after the surgery,the percentage of the height of the anterior vertebral body and the height of the vertebral space in the two groups were significantly increased compared with that before the surgery,and the Cobb Angle was significantly decreased compared with that before the surgery,P<0.05;P>0.05 compared with the percentage of the height of the anterior vertebral body,the height of the intervertebral space and the Cobb Angle in the two groups.2)the amount of intraoperative blood loss in the observation group was less than that in the control group,and the length of incision,the length of intraoperative sacrospinous muscle dissection,and the length of postoperative hospitalization were all shorter in the observation group than in the control group(P<0.05).3)at 1 month after surgery,JOA scores in both groups were significantly higher than those before surgery,P<0.05;JOA score of the observation group was higher than that of the control group,P<0.05.Conclusion:minimally invasive pedicle screw internal fixation for thoracolumbar traumatic fractures has the advantages of definite efficacy,less trauma,less intraoperative blood loss and rapid postoperative recovery.