经皮椎弓根钉微创手术治疗脊柱骨折的疗效分析

Analysis of the efficacy of percutaneous pedicle screw minimally invasive surgery for spinal fractures

目的探讨经皮椎弓根钉微创手术治疗脊柱骨折患者行的效果。方法 68例脊柱骨折患者,根据手术方法不同分为参照组和实验组,各34例。参照组采取常规开放内固定手术治疗,实验组采取经皮椎弓根钉微创手术治疗。比较两组患者临床效果、术中出血量和住院时间、骨折愈合情况、颈椎功能残疾指数(NDI)评分和日本矫形外科协会(JOA)评分。结果实验组术中出血量(75.56±12.51)ml少于参照组的(147.65±18.42)ml,住院时间(8.45±2.36)d短于参照组的(14.25±3.27)d,差异有统计学意义(P<0.05)。实验组疼痛评分、Cobb角和椎体高度丢失量均优于参照组,差异有统计学意义(P<0.05)。治疗前,两组NDI评分和JOA评分比较,差异无统计学意义(P>0.05);治疗后,实验组NDI评分和JOA评分均优于参照组,差异有统计学意义(P<0.05)。实验组治疗总有效率为94.12%(32/34),高于参照组的70.59%(24/34),差异有统计学意义(P<0.05)。结论对脊柱骨折患者行经皮椎弓根钉微创手术治疗可使术中出血量减少,提高骨折愈合效果, NDI评分和JOA评分得到改善,有利于患者尽早恢复。

Objective To discuss the effect of percutaneous pedicle screw minimally invasive surgery for spinal fractures. Methods A total of 68 patients with spinal fractures were divided into control group and experimental group according to different surgical methods, with 34 cases in each group. The control group was treated with conventional open internal fixation surgery, and the experimental group was treated with percutaneous pedicle screw minimally invasive surgery. The clinical efficacy, intraoperative blood loss, hospitalization time, fracture healing status, neck disability index(NDI) score and Japan Orthopedic Association(JOA) score were compared between the two groups. Results The intraoperative blood loss(75.56±12.51) ml of the experimental group was less than(147.65±18.42) ml of the control group, and hospitalization time(8.45±2.36) d was shorter than(14.25±3.27) d of the control group, and the difference was statistically significant(P<0.05). The pain score, vertebral height loss of the experimental group were better than those of the control group, and the difference was statistically significant(P<0.05). Before treatment, there was no statistically significant difference in NDI score and JOA score between the two groups(P>0.05). After treatment, NDI score and JOA score of the experimental group were better than those of the control group, and the difference was statistically significant(P<0.05). The total effective rate of treatment of the experimental group was 94.12%(32/34), which was higher than 70.59%(24/34) of the control group, and the difference was statistically significant(P<0.05). Conclusion Percutaneous pedicle screw minimally invasive surgery for spinal fracture patients can reduce intraoperative blood loss, improve fracture healing effect, and improve NDI score and JOA score, which is conducive to early recovery of patients.