新置钉方式在胸腰椎骨折伴脊髓损伤置钉过程中的应用

Application of new screw placement in thoracolumbar fracture complicated with spinal cord injury

目的本研究将新置钉方式与常规置钉方式作比较,为新置钉方式的应用提供依据。方法收集我院2018年12月至2019年12月我院收住的胸腰椎骨折手术患者57例,分为常规置钉组和新置钉组,两组为同一批患者,常规置钉组依次置入一侧椎弓根钉、固定棒、尾帽连接,之后再依次置入另一侧直至拧紧。新置钉组在常规置钉结束后,按照常规置钉顺序再拧一次原本已经拧紧的双侧螺钉尾帽。比较两种置钉方式结束后尚可进一步拧紧的松动螺钉数量及松动率。结果常规置钉方式结束后有91侧的螺钉松动,可进一步拧紧,松动率为79.82%,新置钉方式结束后有2侧的螺钉松动,松动率为1.75%,两组松动侧数和松动率比较,差异有统计学意义(P<0.05)。结论相较于常规置钉方式,新置钉方式可明显减少术中松动螺钉数量,降低松动率,值得临床推广使用。

Objective To compare the new screw placement with the conventional screw placement and provide the basis for the application of the new screw placement.Methods A total of 57 patients who underwent thoracolumbar fractures operation in our hospital from December 2018 to December 2019 were collected,and they were divided into the conventional screw placement group and the new screw placement group.In the conventional screw placement group,one side of pedicle screw,fixation rod and tail cap were inserted successively,and then the other side was inserted until it was tightened.In the new screw placement group,after the conventional screw placement was finished,the bilateral screw tail caps that have been tightened once again were screwed according to the conventional screw placement sequence.The number and loosening rate of screws that could be tightened further after the two kinds of screw placement methods were compared.Results After the end of conventional screw placement,91 sides of the screws were loose,which could be tightened further,with a loosening rate of 79.82%.After the end of the new screw placement method,2 sides of the screws were loose,with a loosening rate of 1.75%.There were significant differences in the number of loose sides and the loosening rate between the two groups(P<0.05).Conclusion Compared with the conventional screw placement,the new screw placement can significantly reduce the number of loose screws during operation and reduce the loosening rate,which is worthy of clinical application.