经皮椎弓根钉棒跨伤椎内固定治疗胸腰椎骨折患者的效果观察

Observation on the Effect of Percutaneous Pedicle Screw and Rod Fixation for the Treatment of Thoracolumbar Fractures

目的观察经皮椎弓根钉棒跨伤椎内固定治疗胸腰椎骨折患者的效果分析。方法将我院(2018年12月至2020年5月时期)收治以胸腰椎骨折为诊断患者总计80例,以随机数字法分成对照组(40例)与实验组(40例)。其中对照组患者实施开放皮椎弓根钉棒跨伤椎内固定治疗,而实验组患者经皮椎弓根钉棒跨伤椎内固定治疗。对照两组患者手术指标(手术时长、术中出血量、住院时间、并发症发生率),术前、术后1d疼痛VAS评分、Oswestry功能障碍指数(oswestry disability index,ODI)比较。结果实验组患者手术时长短于对照组,术中出血量多于对照组,住院时长短于对照组,且实验组患者术后并发症发生率低于对照组(P<0.05)。两组患者于术前疼痛VAS评分、ODI评分(P>0.05)。两组患者于术后1d疼痛VAS评分、ODI评分较术前明显降低,且实验组均低于对照组(P<0.05)。结论在胸腰椎骨折患者治疗中,以经皮椎弓根钉棒跨伤椎内固定治疗,可明显的缩短手术时长,减少术中出血量,缩短住院时间,降低术后并发症的发生,减轻术后疼痛与功能障碍,效果理想。

Objective To observe the effect of percutaneous pedicle screw and rod fixation on patients with thoracolumbar fractures.Methods A total of 80 patients diagnosed with thoracolumbar fractures in our hospital (from December 2018 to May 2020) were divided into a control group (40 cases) and an experimental group (40 cases) by random number method.Among them,the patients in the control group were treated with open-skin pedicle screw rods for trans-injury vertebral fixation,while the patients in the experimental group were treated with percutaneous pedicle screw-rod trans-vertebral fixation.The operation indexes (operating time,intraoperative blood loss,hospitalization time,and complication rate),pain VAS score,and Oswestry disability index (ODI) were compared between the two groups before and after operation.Results The operation time of the experimental group was shorter than that of the control group,the intraoperative blood loss was more than that of the control group,and the length of hospitalization was shorter than that of the control group,and the incidence of postoperative complications in the experimental group was lower than that of the control group (P<0.05).The preoperative pain VAS score and ODI score of the two groups of patients (P>0.05).The pain VAS score and ODI score of the two groups of patients on the 1st postoperative day were significantly lower than that before the operation,and the experimental group was lower than the control group (P<0.05).Conclusion In the treatment of thoracolumbar vertebral fractures,transcutaneous pedicle screw fixation can significantly shorten the operation time,reduce intraoperative blood loss,shorten hospital stay,and reduce postoperative complications.It is effective in reducing postoperative pain and dysfunction.