后路经椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折临床研究

Clinical Study of Posterior Pedicle Internal Fixation Combined with Vertebroplasty in the Treatment of Thoracolumbar Spinal Fractures in the Elderly

目的:研究后路经椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折的临床效果。方法:选择2018年12月-2019年10月入院接受治疗的68例老年胸腰段脊柱骨折患者,按照抽签法将其分为对照组和研究组,各34例。对照组给予短节段椎弓根钉内固定手术治疗,研究组给予后路经椎弓根内固定结合椎体成形术治疗,比较两组临床效果。结果:术前,两组脊柱后凸Cobb’s角、椎体前缘高度压缩率、椎体后缘高度压缩率比较,差异均无统计学意义(P>0.05);术后,研究组脊柱后凸Cobb’s角(4.2±0.6)°、椎体前缘高度压缩率(7.3±2.2)%、椎体后缘高度压缩率(1.7±0.2)%,均低于对照组的(4.9±1.9)°、(16.7±7.7)%、(3.8±1.9)%,差异均有统计学意义(P<0.05)。术后对两组患者均随访3个月,研究组不良反应发生率明显优于对照组,差异有统计学意义(P<0.05)。结论:老年胸腰段脊柱骨折的临床治疗中应用后路经椎弓根内固定结合椎体成形术临床效果显著,可为预后治疗奠定基础,可应用于临床上。

Objective:To study the clinical effect of posterior pedicle internal fixation combined with vertebroplasty in the treatment of thoracolumbar spine fractures in the elderly.Method:Sixty-eight elderly patients with thoracolumbar spine fractures admitted in our hospital from December 2018 to October 2019 were selected and divided into the control group and the study group according to the method of lottery,with 34 cases each group.The control group was treated with short-segment pedicle screw internal fixation.The study group was treated with posterior pedicle internal fixation combined with vertebroplasty.The clinical effects of the two groups were compared.Result:Before operation,there were no significant differences in the kyphosis Cobb’s angle,the compression rate of anterior edge height of vertebral body and the compression rate of posterior edge height of vertebral body between the two groups(P>0.05).After operation,the kyphosis Cobb’s angle(4.2±0.6)°,the compression rate of anterior edge height of vertebral body(7.3±2.2)%,and the compression rate of posterior edge height of vertebral body(1.7±0.2)%in the study group were all lower than(4.9±1.9)°,(16.7±7.7)%and(3.8±1.9)%,in the control group,the differences were statistically significant(P<0.05).The two groups were followed up for 3 months after operation,and the incidence of adverse reactions in the study group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:The clinical application of posterior pedicle internal fixation combined with vertebroplasty in the clinical treatment of thoracolumbar spine fractures in the elderly has a significant clinical effect,which can lay the foundation for treatment of prognosis,it can be applied in clinic.