椎旁肌间隙入路椎弓根螺钉内固定结合伤椎置钉治疗32例胸腰椎骨折的临床研究

Clinical study of 32 cases of thoracolumbar fracture treated with pedicle screw fixation and traumatized screw through paravertebral space approach

目的:探讨椎旁肌间隙入路椎弓根螺钉内固定结合伤椎置钉治疗胸腰椎骨折的临床疗效。方法:选取64例胸腰椎骨折患者随机分为观察组和对照组各32例。观察组行椎旁肌间隙入路椎弓根螺钉内固定结合伤椎置钉,对照组行传统胸腰椎后侧正中切口入路跨伤椎置钉技术椎弓根螺钉内固定治疗,对比两组手术情况、术后恢复情况等。结果:与对照组相比,观察组术中出血量低,下床活动时间短,后1周ODI评分高,Cobb角小,椎体前缘高度高,VAS评分低(P<0.05)。结论:椎旁肌间隙入路椎弓根螺钉内固定结合伤椎置钉治疗胸腰椎骨折可有效减少术中出血量,促进早期下床活动,加快功能恢复,减轻患者疼痛程度。

Objective:To explore the clinical effect of pedicle screw internal fixation combined with screw placement in the treatment of thoracolumbar fractures.Methods:Sixty four patients with thoracolumbar fracture were randomly divided into an observation group and a control group.The observation group was treated with pedicle screw internal fixation through paravertebral space approach combined with pedicle screw internal fixation through trauma while the control group was treated with pedicle screw internal fixation through traditional thoracolumbar posterior median incision approach.The operation,postoperative recovery,dysfunction,Cobb angle,anterior height of vertebral body and the degree of pain were compared between the two groups.Results:Compared with the control group,the observation group had lower intraoperative bleeding volume,shorter time for getting out of bed,higher ODI score,smaller Cobb angle,higher anterior height of vertebral body and lower VAS score(P<0.05).Conclusion:The treatment of thoracolumbar fractures with pedicle screw fixation and pedicle screw placement can effectively reduce the amount of intraoperative bleeding,promote early getting out of bed,accelerate functional recovery and reduce the degree of pain.