后路微创经皮与经肌间隙入路椎弓根螺钉治疗胸腰椎骨折的效果比较

Effect comparison of posterior minimally invasive percutaneous and transforaminal approach pedicle screws in the treatment for thoracolumbar fractures

目的比较后路微创经皮与经肌间隙入路椎弓根螺钉治疗胸腰椎骨折的临床效果。方法选取2015年6月~2018年12月于我院接受治疗的40例胸腰椎骨折患者作为研究对象,按随机数字表法将其分为对照组(20例)和观察组(20例),观察组施行后路微创经皮入路椎弓根螺钉治疗,对照组行经肌间隙入路椎弓根螺钉治疗。比较两组患者术后的伤椎前缘高度、矢状面椎体后凸Cobb角等手术指标以及手术疗效。结果两组患者术后1周、术后6个月的伤椎前缘高度均大于本组术前,矢状面椎体后凸Cobb角均小于本组术前,差异有统计学意义(P<0.05);两组术前、术后1周、术后6个月的伤椎前缘高度、矢状面椎体后凸Cobb角比较,差异无统计学意义(P>0.05);两组患者的临床总有效率比较,差异无统计学意义(P>0.05)。结论胸腰椎骨折患者经后路微创经皮与经肌间隙入路椎弓根螺钉治疗,其临床效果均较高,可根据患者意愿选择手术治疗方式。

Objective To compare the clinical effect of posterior minimally invasive percutaneous and transforaminal approach pedicle screws in the treatment for thoracolumbar fractures.Methods Forty patients with thoracolumbar fractures who were treated in our hospital from June to February 2018 were selected as the research objects.They were divided into a control group(20 cases)and an observation group(20 cases)according to the random number table method.The observation group received minimally invasive percutaneous pedicle screw treatment,and the control group received transmuscular pedicle screw treatment.The surgical parameters such as the height of the anterior edge of the injured vertebrae,the Cobb angle of the sagittal vertebral kyphosis and the surgical efficacy of the two groups were compared.Results The height of the anterior edge of the injured vertebrae of patients of the two groups at 1 week and 6 months after surgery was greater than that in the group before surgery,and the Cobb angle of the sagittal vertebral kyphosis was smaller than that in the group before surgery,the differences were statistically significant(P<0.05).There were no significant differences in the height of the anterior edge of the injured vertebrae and the Cobb angle of the sagittal vertebral kyphosis between the two groups before surgery,1 week after surgery and 6 months after surgery(P>0.05).There was no significant difference in the total clinical efficiency of patients between the two groups(P>0.05).Conclusion Patients with thoracolumbar fractures undergo posterior minimally invasive percutaneous and transforaminal approach pedicle screws,which have high clinical effect,and surgical treatment can be selected according to the patient′s wishes.