内固定结合椎体成形术对脊柱骨折的治疗作用研究

Study on the Therapeutic Effect of Internal Fixation Combined with Vertebroplasty on Spinal Fracture

目的分析内固定结合椎体成形术对脊柱骨折的治疗作用。方法选取兴山县人民医院2016年5月至2017年5月收治的60例胸腰段脊柱骨折患者为研究对象,给予患者两种不同的手术方式,同时分成观察组和对照组,每组30例。其中对照组接受单纯内固定治疗,观察组接受内固定结合椎体成形术,观察比较两组患者手术时间、术中失血量、下地时间、术后负重时间、住院时间、骨折愈合时间;对比两组患者的Cobb角、伤椎前高压缩比、脊柱功能评分、术前、术后1周、术后12个月、术后24个月、术后36个月的前缘和后缘椎体压缩率及椎管侵占率;并对手术引起的并发症情况进行分析。结果观察组的手术时间、术中失血量、下地时间与对照组无显著性差异,而术后负重时间、住院时间与骨折愈合时间均少于对照组,且差异具有统计学意义(P<0.05)。观察组的Cobb角、伤椎前高压缩比、脊柱功能评分均要优于对照组,(P<0.05)。观察组术后1周、术后12个月、术后24个月、术后36个月的前缘椎体压缩率、后缘椎体压缩率及椎管侵占率均要优于对照组,两组患者均发生肺部感染1例,无其他严重并发症发生。结论内固定结合椎体成形术对脊柱骨折的治疗作用显著,具有较高的稳定性,可以减少患者的住院时间及骨折愈合时间,有利于促进患者骨折部位的恢复,同时有利于促进患者骨折部位的恢复。

Objective To analyze the therapeutic effect of internal fixation combined with vertebroplasty on spinal fracture.Methods Totally 60 patients with thoracolumbar spine fractures in Xingshan People's Hospital from May 2016 to May 2017 were selected as the research objects,and were given two different surgical methods,which were simultaneously divided into observation group and control group,with 30 cases in each group.Among them,the control group received internal fixation alone,while the observation group received internal fixation combined with vertebroplasty.The operation time,blood loss during operation,time in the field,weight bearing time after operation,hospitalization time and fracture healing time of the two groups were observed and compared.Cobb angle,high compression ratio before vertebral injury,spinal function score,anterior and posterior vertebral compression ratio and spinal canal invasion rate before,1 week after,12 months after,24 months after and 36 months after operation were compared between the two groups.And the complications caused by the operation were analyzed.Results There was no significant difference in operation time,blood loss during operation,and time of going down to the ground between the observation group and the control group,but the time of weight bearing,hospitalization and fracture healing after operation were less than those of the control group,and the difference was statistically significant(P<0.05).Cobb angle,high compression ratio before vertebral injury and spinal function score in the observation group were better than those in the control group(P<0.05).The anterior vertebral compression rate,posterior vertebral compression rate and spinal canal invasion rate in observation group were better than those in control group 1 week after operation,12 months after operation,24 months after operation and 36 months after operation.One case of pulmonary infection occurred in both groups,and no other serious complications occurred.Conclusion Internal fixation combined with vertebroplasty has a significant effect on the treatment of spinal fracture,which has high stability,can reduce the hospitalization time and fracture healing time of patients,and is conducive to promoting the recovery of patients'fracture sites.