经皮椎弓根钉微创手术对脊柱骨折患者的有效性及患者炎症反应发生的影响

Minimally invasive surgery with percutaneous pedicle screw for patients with spinal fracture and its effect on inflammatory reaction

目的探讨经皮椎弓根钉微创手术对脊柱骨折患者治疗有效性及患者炎症反应发生的影响。方法选取本院2017年2月至2018年8月期间收治的108例脊柱骨折患者,利用随机数表法分为两组,各54例。对照组患者行传统开放性内固定术,观察组行经皮椎弓根钉微创手术,对比两组临床疗效、炎症反应发生、影像学参数及并发症。结果 观察组的治疗总有效率为94.44%,对照组的治疗总有效率为88.89%,两组治疗总有效率比较,差异无统计学意义(P>0.05);术后,观察组CRP、IL-2、IL-6水平[(19.27±4.34)mg/L、(8.22±1.74)mg/L、(25.07±3.42)mg/L]均较对照组[(28.12±4.56)mg/L、(10.15±1.83)mg/L、(30.79±4.14)mg/L]低,差异均有统计学意义(均P<0.05);术后,观察组椎体前缘高度、矢状位指数及后凸Cobb角[(95.36±13.75)%、(94.63±13.54)%、(4.17±0.95)°]与对照组[(94.93±13.62)%、(94.16±13.48)%、(4.38±1.02)°]相比,差异均无统计学意义(均P>0.05);观察组并发症发生率为5.56%,对照组并发症发生率为9.26%,两组并发症发生率对比,差异无统计学意义(P>0.05)。结论 经皮椎弓根钉微创手术治疗脊柱骨折疗效确切,可有效减轻患者炎症反应,且并发症较少,值得临床推广。

Objective To investigate the effect of percutaneous pedicle screw minimally invasive surgery on the efficacy and inflammatory reaction of patients with spinal fracture. Methods 108 patients with spinal fracture treated in our hospital from February, 2017 to August, 2018 were randomly divided into a control group and an observation group group, 54 cases for each group. The control group was treated with traditional open internal fixation, and the observation group with minimally invasive surgery with percutaneous pedicle screw. The clinical efficacies, inflammatory reaction, imaging parameters, and complications were compared between the two groups. Results The total effective rate was 94.44% in the observation group, and 88.89% in the control group (P > 0.05). After the operation, the levels of CRP, IL-2, and IL-6 were higher in the observation group than in the control group [(19.27 ±4.34) mg/L vs.(28.12 ±4.56) mg/L,(8.22 ±1.74) mg/L vs.(10.15 ±1.83) mg/L, and (25.07 ±3.42) mg/L vs.(30.79 ±4.14) mg/L;all P < 0.05]. After the operation, the anterior edge height, sagittal index,and kyphosis Cobb angle were (95.36±13.75)%,(94.63±13.54)%, and (4.17±0.95)°in the observation group, and were (94.93±13.62)%,(94.16±13.48)%, and (4.38±1.02)°in the control group, with no statistical differences (all P > 0.05). The incidence of complications was 5.56% in the observation group, and 9.26% in the control group (P > 0.05). Conclusion Minimally invasive surgery with percutaneous pedicle screw in the treatment of patients with spinal fracture is effective and can effectively reduce their inflammation and has few complications, so it is worth for clinical popularization.