经肌间隙椎弓根钉固定结合椎体内植骨术在胸腰椎骨折中的应用

Application of transpedicular screw fixation combined with vertebral bone grafting in thoracolumbar fractures

目的探讨经肌间隙椎弓根钉固定结合椎体内植骨术在胸腰椎骨折中的治疗效果。方法选取2016年6月-2020年3月本院收治的78例胸腰椎骨折患者为研究对象,依据手术方式分为观察组及对照组各39例,观察组患者采用经肌间隙椎弓根钉固定结合椎体内植骨术进行治疗,对照组患者采用传统椎弓根钉固定结合椎体内植骨术治疗。观察比较两组患者的围手术期出血量、手术时间、伤椎前缘高度比、Cobb角变化、VAS评分等指标。结果观察组患者的有效率显著高于对照组(P<0.05),手术时间显著短于对照组(P<0.05),出血量显著低于对照组(P<0.05);观察组患者术后的Cobb角、椎体前缘高度均显著高于对照组(P<0.05),VAS评分显著降低于对照组(P<0.05);观察组并发症发生率5.13%,显著低于对照组的12.82%,但差异无统计学意义(P>0.05)。结论经肌间隙椎弓根钉固定结合椎体内植骨术治疗胸腰椎骨折,能够改善手术指标、减轻患者痛苦、改善预后,是一种安全、有效的治疗方式。

Objective To investigate the effect of transpedicular screw fixation combined with vertebral bone grafting in the treatment of thoracolumbar fractures.Methods From June 2016 to March 2020,78 patients with thoracolumbar fractures in our hospital were selected in the research.According to the operation Methods,the patients were divided into observation group and control group,with 39 cases in each group.The observation group was treated with intramuscular pedicle screw fixation combined with vertebral bone grafting,and the control group was treated with traditional pedicle screw fixation combined with vertebral bone grafting.Results The effective rate of the observation group was significantly higher than that of the control group(P<0.05),the operation time was significantly shorter than that of the control group(P<0.05),and the amount of bleeding was significantly lower than that of the control group(P<0.05).The postoperative Cobb angle and anterior vertebral height of the observation group were significantly higher than those of the control group(P<0.05),and the VAS score was significantly lower than that of the control group(P<0.05).The incidence rate of complications in the observation group was 5.13%,which was lower than 12.82%in the control group,but the difference was not statistically significant(P>0.05).Conclusion s Transpedicular screw fixation combined with vertebral bone grafting has significant advantages in the treatment of thoracolumbar fractures.It can improve the operation index,reduce the pain of patients and improve the prognosis of patients.It is a safe and effective treatment method.