CBT螺钉置入技术在治疗胸腰椎骨质疏松爆裂性骨折的疗效分析

目的评价CBT螺钉置入技术在治疗胸腰椎骨质疏松爆裂骨折的临床疗效。方法采用随机分组将60例胸腰椎骨质疏松爆裂性骨折的患者分为观察组与对照组,每组各30例。对照组采用传统椎弓根螺钉置入法,观察组采用CBT螺钉置入法。术后随访半年,记录并且比较两组患者在手术时间、术中出血量、住院时间、JOA评分、ODI评分、VAS评分、Cobb角及伤椎前后缘高度比值的差异。结果两组患者的性别、年龄、病变节段及病程比较,差异无统计学意义(P>0.05)。观察组患者的住院时间、术中出血量少于对照组,差异有统计学意义(P<0.05),观察组的手术时间虽总体少于对照组,但差异无统计学意义(P>0.05)。两组患者术后7d的JOA评分、ODI评分、VAS评分比较,差异有统计学意义(P<0.05),而术前及末次的评分比较,差异均无统计学意义(P>0.05)。两组患者术前、术后7d及末次Cobb角及伤椎前后缘高度比值的比较,其中术前差异无统计学意义(P>0.05),其余均有统计学意义(P<0.05)。结论采用CBT螺钉置入技术能缩短住院时间、手术时间,减少术中出血量,更好地复位并维持伤椎高度。两种手术方式均能减轻患者的腰部疼痛和功能障碍,改善患者脊柱的生理功能,术后短期内CBT螺钉置入技术更具有优势,提高了螺钉的把持力,降低了螺钉松动脱出的风险。

Objective To evaluate the clinical efficacy of CBT screw placement technology in the treatment of thoracolumbar osteoporotic burst fractures.Methods Sixty patients with thoracolumbar osteoporotic burst fractures treated in Zhoushan Traditional Chinese Medicine Hospital from February 2017 to June 2019 were randomly divided into observation group and control group,with 30 cases in each group.The control group used the traditional pedicle screw placement method,and the observation group used the CBT screw placement method.Follow-up for six months after operation was performed to record and compare the differences in surgical time,intraoperative blood loss,length of hospital stay,JOA score,ODI score,VAS score,Cobb angle,and height ratio of the anterior and posterior edges of the injured vertebra.Results There was no significant difference in gender,age,lesion segment and course of disease between the two groups(P>0.05),and the randomization was better.Patients in the observation group had shorter hospital stays and intraoperative blood loss than the control group,and the differences were statistically significant(P<0.05).Although the operation time in the observation group was generally shorter than the control group,the differences were not statistically significant(P>0.05).There was a stistically significant difference in JOA score,ODI score,and VAS score between the two groups of patients at 7 days after surgery(P<0.05),but there was no significant difference in the comparison of preoperative and final scores(P>0.05).Comparison of the ratio of Cobb angle and the height of the anterior and posterior edges of the injured vertebrae before and after surgery,and at the last 7 days after operation in the two groups.The preoperative differences were not staistially significant(P>0.05),and the rest were staistially significant(P<0.05).Conclusion It shows that the use of CBT screw placement technology can shorten the length of hospital stay,operation time,reduce the amount of intraoperative bleeding,and better reduce and maintain the injured vertebral height.In the long run,both surgical methods can alleviate waist pain and dysfunction of the patient,and improve the physiological function of the patient's spine.However,CBT screw placement technology has more advantages in the short term after surgery,which improves the holding power of the screw and reduces the risk of loosening screws.