UpASSⅡ与USS后路椎弓根螺钉内固定系统治疗胸腰椎骨折的疗效对比

Comparison of therapeutic effects between UpASSⅡand USS posterior pedicle screw internal fixation system in the treatment of thoracolumbar fractures

目的比较UpASSⅡ与USS后路椎弓根螺钉内固定系统治疗胸腰椎骨折的疗效差异。方法回顾性分析2015年12月至2018年6月东莞光华医院收治的80例胸腰椎骨折患者的临床资料,根据内固定器械的不同分为UpASSⅡ组和USS组(每组40例),分别采用UpASSⅡ和USS系统进行内固定。比较两组患者围手术期指标、伤椎前缘高度和Cobb角,采用视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI)评估两组患者术后疼痛症状及胸腰椎功能的改善情况。结果两组手术时间、骨折愈合时间相似(P>0.05),UpASSⅡ组患者切口长度、术中出血量、下床时间和住院时间均少于USS组(P<0.05)。术后3、6个月两组患者伤椎前缘高度、Cobb角、VAS评分和ODI较术前均有改善;UpASSⅡ组术后3、6个月VAS评分、ODI均优于USS组(P<0.05)。结论UpASSⅡ与USS两种后路椎弓根螺钉内固定系统治疗胸腰椎骨折短期疗效均良好,在术后伤椎高度恢复及维持Cobb角方面效果相当;与USS内固定相比,UpASSⅡ内固定手术切口更小,出血量更少,疼痛缓解效果更好,患者胸腰椎功能恢复更佳。

Objective To compare the differences of therapeutic effects between posterior pedicle screw internal fixation systems of UpASSⅡand USS in the treatment of thoracolumbar fractures.Methods Clinical data of 80 patients with thoracolumbar fractures who treated from December 2015 to June 2018 in Dongguan Guanghua Hospital were retrospectively analyzed.According to the different internal fixation devices,they were divided into UpASSⅡand USS groups(n=40),the internal fixation procedure was performed with UpASSⅡor USS system respectively.Perioperative indexes,height of the anterior edge of the injured vertebrae and Cobb angle were compared between the two groups.The improvement of pain and thoracolumbar functions were evaluated by visual analogue scale(VAS)and Oswestry disability index(ODI)respectively.Results Operation time and fracture healing time of the two groups were similar(P>0.05).Incision length was shorter,intraoperative estimate blood loss was lower,ambulating time and hospitalization stay were shorter in UpASSⅡgroup than those in USS group(P<0.05).At 3,6 months after the operation,height of the anterior edge of the injured vertebrae,Cobb angle,VAS score and ODI of the two groups were all improved compared with those before the operation;and the VAS score and ODI at 3,6 months in UpASSⅡgroup were better than those in USS group(P<0.05).Conclusions Both posterior pedicle screw internal fixation systems,UpASSⅡand USS,have good short-term effects in the treatment of thoracolumbar fractures with similar effect in the recovery of he height of injured vertebrae and maintenance of Cobb angle;Compared with USS,UpASSⅡhas the advantages of shorter incision length,less bleeding and better pain relief and better recovery of thoracolumbar function.