经皮椎弓根螺钉短节段内固定联合经皮伤椎终板撬拨复位螺钉技术治疗胸腰椎骨折的效果及安全性

Efficacy and safety of percutaneous pedicle screw short-segment internal fixation combined with endplate reduction percutaneous pedicle screw technique for thoracolumbar fractures

目的观察经皮椎弓根螺钉短节段内固定联合经皮伤椎终板撬拨复位螺钉技术治疗胸腰椎骨折的效果及安全性。方法回顾性分析2016年1月至2019年1月我院收治的120例胸腰椎骨折患者的临床资料,根据治疗方式的不同将患者分为对照组和观察组,各60例。对照组单独给予经皮椎弓根螺钉短节段内固定治疗,观察组同时联合经皮伤椎终板撬拨复位螺钉技术治疗。比较两组的治疗效果。结果术后6个月,观察组的VAS评分低于对照组(P<0.05)。观察组术后1个月的伤椎终板高度比高于对照组,矢状面后凸Cobb角显著小于对照组,观察组术后6个月的伤椎前缘高度比、伤椎终板高度比均高于对照组,矢状面后凸Cobb角小于对照组(P<0.05)。结论经皮椎弓根螺钉短节段内固定联合经皮伤椎终板撬拨复位螺钉技术治疗胸腰椎骨折能增强骨折复位效果,最大限度恢复伤椎高度,并促使上终板复位,是一种较好的微创手术治疗方式。

Objective To observe the efficacy and safety of percutaneous pedicle screw short-segment internal fixation combined with endplate reduction percutaneous pedicle screw technique for thoracolumbar fractures.Methods The clinical data of 120 patients with thoracolumbar fractures admitted in our hospital from January 2016 to January 2019 were analyzed retrospectively.According to the different treatment methods,the patients were divided into control group and observation group,with 60 cases in each group.The control group was treated with percutaneous pedicle screw shortsegment internal fixation alone,while the observation group was combined with endplate reduction percutaneous pedicle screw technique at the same time.The therapeutic effects of the two groups were compared.Results At 6 months after operation,the VAS score of the observation group was lower than that of the control group(P<0.05).The height ratio of the injured vertebral endplate in the observation group was higher than that in the control group,and the Cobb angle of sagittal kyphosis was significantly lower than that in the control group at 1 month after operation;the height ratio of anterior edge of injured vertebra,height ratio of the injured vertebral endplate in the observation group were higher than those in the control group,and the Cobb angle of sagittal kyphosis was significantly lower than that in the control group at 6 month after operation(P<0.05).Conclusion Percutaneous pedicle screw short-segment internal fixation combined with endplate reduction percutaneous pedicle screw technique in the treatment of thoracolumbar fracture can enhance the reduction effect of fracture,restore the height of injured vertebra to the maximum extent,and promote the reduction of upper endplate,which is a better minimally invasive surgical treatment.