比较经皮微创与开放椎弓根钉内固定术治疗脊柱骨折的效果

Comparison of the effects of percutaneous minimally invasive and open pedicle screw internal fixation in the treatment of spinal fractures

目的比较经皮微创与开放椎弓根钉内固定术治疗脊柱骨折的效果。方法选取2017年7月至2020年5月本院收治的102例脊柱骨折患者作为研究对象,按照随机数字表法分为实验组(n=52)与对照组(n=50)。实验组采用经皮微创椎弓根钉内固定术治疗,对照组采用开放椎弓根钉内固定术治疗,比较两组治疗效果、围术期指标、影像学指标、NRS评分及并发症发生率。结果实验组治疗总有效率为96.15%,明显高于对照组的82.00%,差异具有统计学意义(P<0.05)。实验组手术时间、住院时间、切口长度均短于对照组,术中出血量、术后引流量少于对照组,差异具有统计学意义(P<0.05)。治疗后,两组Cobb’s角均降低,椎体前缘高度、椎体矢状面指数均升高,且实验组Cobb’s角低于对照组,椎体前缘高度、椎体矢状面指数高于对照组,差异具有统计学意义(P<0.05)。治疗后,两组NRS评分均降低,且实验组低于对照组,差异具有统计学意义(P<0.05)。实验组并发症发生率为5.77%,明显低于对照组的22.00%,差异具有统计学意义(P<0.05)。结论与开放椎弓根钉内固定术比较,经皮微创椎弓根钉内固定术治疗效果更显著,术中出血量更少,住院时间更短,能显著改善椎体情况,降低术后并发症发生率,患者康复更快,安全性较高,值得临床推广应用。

Objective To compare the effects of percutaneous minimally invasive and open pedicle screw internal fixation in the treatment of spinal fractures.Methods 102 patients with spinal fractures admitted to our hospital from July 2017 to May 2020 were selected as the research subjects,and they were divided into experimental group(n=52)and control group(n=50)according to the random number table method.The experimental group was treated with percutaneous minimally invasive pedicle screw internal fixation,and the control group was treated with open pedicle screw internal fixation.The treatment effects,perioperative indicators,imaging indicators,NRS scores and complications rates were compared between the two groups.Results The total effective rate of treatment in the experimental group was 96.15%,which was significantly higher than 82.00%in the control group,the difference was statistically significant(P<0.05).The operation time,hospitalization time,and incision length of the experimental group were shorter than those of the control group,and the amount of intraoperative blood loss and postoperative drainage were less than those of the control group,the difference was statistically significant(P<0.05).After treatment,the Cobb's angle in both two groups were decreased,the anterior edge height of the vertebral body and the vertebral body sagittal plane index increased,and the Cobb's angle of the experimental group was lower than the control group,and the anterior edge height of the vertebral body and the vertebral body sagittal plane index were higher than those of the control group,the difference was statistically significant(P<0.05).After treatment,the NRS scores of the two groups were reduced,and the experimental group was lower than the control group,the difference was statistically significant(P<0.05).The complication rate in the experimental group was 5.77%,which was significantly lower than 22.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with open pedicle screw internal fixation,the treatment effect of percutaneous minimally invasive pedicle screw fixation is more significant,with less intraoperative blood loss and shorter hospital stay,which can significantly improve the condition of the vertebral body and reduce surgery complications occur later,promote faster recovery of patients with higher safety,and it is worthy of clinical application.