微创经皮椎弓根螺钉内固定术在胸腰椎骨折患者中的应用效果

Practical effect of minimally invasive percutaneous pedicle screw internal fixation in patients with thoracolumbar fractures

目的探讨微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的临床效果。方法86例胸腰椎骨折患者,随机分为微创组与常规组,每组43例。微创组应用微创经皮椎弓根螺钉内固定术治疗,常规组应用传统开放后路椎弓根螺钉内固定术治疗。对比两组患者术中出血量、手术时间、住院时间,术后疼痛评分及睡眠质量评分,术前、术后6个月伤椎前缘高度比和伤椎Cobb角,并发症发生情况。结果微创组患者术中出血量(82.1±34.2)ml少于常规组的(217.4±41.7)ml,手术时间(110.3±20.1)min、住院时间(8.17±1.02)d短于常规组的(127.5±21.3)min、(14.70±1.30)d,差异具有统计学意义(P<0.05)。术后,微创组患者疼痛评分(2.17±0.43)分、睡眠质量评分(4.21±0.47)分均低于常规组的(4.35±0.41)、(10.10±0.53)分,差异具有统计学意义(P<0.05)。术后6个月,两组患者伤椎前缘高度比、伤椎Cobb角均优于本组术前,差异具有统计学意义(P<0.05)。微创组患者并发症发生率明显低于常规组,差异具有统计学意义(P<0.05)。结论对于胸腰椎骨折患者应用微创经皮椎弓根螺钉内固定手术治疗效果明显,患者恢复快,痛苦少,可有效改善预后,适宜在临床广泛使用。

Objective To discuss the clinical effect of minimally invasive percutaneous pedicle screw internal fixation in patients with thoracolumbar fractures.Methods A total of 86 patients with thoracolumbar fractures were randomly divided into minimally invasive group and conventional group,with 43 cases in each group.Minimally invasive group was treated with minimally invasive percutaneous pedicle screw internal fixation,and conventional group was treated with traditional open posterior pedicle screw internal fixation.The amount of intraoperative hemorrhage,operation time,hospitalization time,postoperative pain score,sleep quality score,anterior height ratio of injured vertebrae and the Cobb angle of the injured vertebra before and 6 months after the operation and occurrence of complications were compared between the two groups.Results The amount of intraoperative hemorrhage(82.1±34.2)ml of minimally invasive group was less than(217.4±41.7)ml of conventional group,operation time(110.3±20.1)min and hospitalization time(8.17±1.02)d were shorter than(127.5±21.3)min and(14.70±1.30)d of conventional group,and the difference was statistically significant(P<0.05).After operation,pain score(2.17±0.43)points and sleep quality score(4.21±0.47)points of minimally invasive group were lower than(4.35±0.41)and(10.10±0.53)points of conventional group,and the difference was statistically significant(P<0.05).6 months after operation,anterior height ratio of injured vertebrae and the Cobb angle of the injured vertebra of the two groups were better than those before treatment,and the difference was statistically significant(P<0.05).The incidence of complications of minimally invasive group was obviously lower than that of the conventional group,and the difference was statistically significant(P<0.05).Conclusion For patients with thoracolumbar fractures,minimally invasive percutaneous pedicle screw internal fixation has obvious effect,and can effectively improve the prognosis.Patients recover quickly with less pain,which is suitable for wide use in clinic.