经皮椎弓根钉内固定治疗胸腰椎骨折的效果

Effect of Percutaneous Pedicle Screws Fixation in the Treatment of Thoracolumbar Fractures

目的:研究经皮椎弓根钉内固定治疗无神经损伤的胸腰椎骨折的临床效果。方法:选取2016年10月-2018年5月笔者所在医院收治的50例无神经损伤的胸腰椎骨折患者,采用随机数字表法分为微创组(经皮椎弓根钉内固定术)及开放组(传统开放椎弓根钉内固定术),各25例。比较两组住院时间、手术时间、术中出血量、切口长度、VAS评分、伤椎后凸Cobb’s角、伤椎椎体前缘高度比及并发症发生率。结果:微创组住院时间、手术时间、术中出血量、切口长度、术后即刻VAS评分均优于开放组,差异均有统计学意义(P<0.05)。两组末次随访VAS评分、伤椎后凸Cobb’s角、伤椎椎体前缘高度比、并发症发生率比较,差异均无统计学意义(P>0.05)。结论:经皮椎弓根钉内固定治疗胸腰椎骨折与开放手术有相似的临床效果,但经皮椎弓根钉内固定治疗具有创伤小、出血少、恢复快等优点。

Objective:To study clinical effect of percutaneous pedicle screws fixation in the treatment of thoracolumbar fracture without nerve injury.Method:From October 2016 to May 2018,50 cases with thoracolumbar fracture without nerve injury were selected and divided into the minimally invasive group(percutaneous pedicle screws fixation)and the open group(open pedicle screws fixation)by random number table,and 25 cases in each group.Hospitial stay,operation time,intraoperative blood loss,incision length,VAS score,kyphosis Cobb’s angle,the ratio of height of the anterior edge of the vertebra and complication rate were compared between the two groups.Result:Hospitial stay,operation time,intraoperative blood loss,incision length,VAS score at postoperation in the minimally invasive group were better than those of the open group,and the differences were statistically significant(P<0.05).VAS scores at the last follow-up,kyphosis Cobb’s angle,the ratio of height of the anterior edge of the vertebra and complication rate were compared between the two groups,and the differences were not statistically significant(P>0.05).Conclusion:Percutaneous pedicle screws fixation for thoracolumbar fractures has similar clinical effects as open surgery,and percutaneous pedicle screws fixation has advantages of less trauma,less blood loss,rapid recovery and less operation complications.