后路短节段经皮椎弓根空心螺钉内固定结合伤椎强化治疗老年胸腰椎爆裂性骨折的效果

The Effect of Posterior Short Segment Percutaneous Pedicle Hollow Screw Internal Fixation Combined with Strengthening of Injured Vertebrae in the Treatment of the Elderly Patients with Thoracolumbar Burst Fractur

目的:分析老年胸腰椎爆裂性骨折患者应用后路短节段经皮椎弓根空心螺钉内固定、伤椎强化技术联合治疗的临床效果及对疼痛影响作用。方法:纳入2018年1月-2019年12月本院收治的74例老年胸腰椎爆裂性骨折患者为研究对象。根据不同手术方式将患者分为研究组、对照组,研究组37例采用后路短节段经皮椎弓根空心螺钉内固定、伤椎强化技术联合治疗,对照组37例采用经皮椎体后凸成形术治疗,对比两组临床疗效。结果:研究组总有效率(97.30%)显著高于对照组(78.38%),差异有统计学意义(P<0.05);术后3个月,研究组胸腰椎神经功能JOA评分(24.1±1.6)分,显著高于对照组的(20.3±1.9)分;研究组疼痛视觉模拟VAS评分(2.1±0.5)分,伤椎矢状面Cobb角(3.0±0.8)°,手术时间(37.8±5.9)min,术中出血量(23.4±4.5)ml,明显低于对照组的(3.0±0.9)分、(7.8±1.6)°、(76.0±13.8)min、(46.0±8.8)ml,差异有统计学意义(P<0.05);研究组椎体前、后缘高度压缩恢复率明显比对照组高,各组数据比较差异有统计学意义(P<0.05)。结论:老年胸腰椎爆裂性骨折损伤程度严重,后路短节段经皮椎弓根空心螺钉内固定、伤椎强化技术联合治疗可稳定伤椎,保护脊髓神经,恢复伤锥高度,缓解疼痛。

Objective:To analyze the clinical effect and the effect on pain of the elderly patients with thoracolumbar burst fracture treated with posterior short segment percutaneous pedicle hollow screw internal fixation and injured vertebrae strengthening technology.Method:A total of 74 elderly patients with thoracolumbar burst fracture who were admitted in our hospital from January 2018 to December 2019 were selected as the research subject.The patients were divided into the study group and the control group according to the different treatment methods,37 elderly patients in the study group were treated with posterior short segment pedicle hollow screw internal fixation and vertebral injury strengthening technology.37 cases of patients in the control group were treated with percutaneous kyphoplasty.The clinical effect in two groups was compared.Result:The total effective rate in the study group(97.30%)was significantly higher than that of the control group(78.38%),it was statistically significant(P<0.05).Three months after surgery,the score of thoracolumbar JOA(24.1±1.6)points,significantly higher than(20.3±1.9)points in the control group.The scores of pain visual analogue VAS(2.1±0.5)points,sagittal Cobb angle(3.0±0.8)°,operative time(37.8±5.9)min,intraoperative bleeding(23.4±4.5)ml were significantly lower than(3.0±0.9)points,(7.8±1.6)°,(76.0±13.8)min,(46.0±8.8)ml of the control group,there were statistically significant(P<0.05).The recovery rates of anterior and posterior vertebral height compression in the study group were significantly higher than those in the control group(P<0.05).Conclusion:The degree of thoracolumbar burst fracture injury in the elder is serious.The posterior short segment percutaneous pedicle hollow screw internal fixation and strengthening of injured vertebrae technique can stabilize the injured vertebrae,protect the spinal nerves,recover the height of the injured vertebrae and relieve the pain.