经皮椎弓根钉微创与开放椎弓根钉内固定对胸腰椎段脊柱骨折的治疗效果和治疗后生活质量水平变化的比较

Comparison of Treatment Effect and Posttreatment Quality of Life in Patients with Thoracolumbar Vertebral Fracture Treated with Minimally Invasive Percutaneous Pedicle Screw Fixation and Open Pedicle Screw Fixation

目的:比较经皮椎弓根钉微创和开放椎弓根钉内固定在胸腰椎段脊柱骨折患者中的临床治疗效果及对患者生活质量水平的影响。方法:选择2010年6月-2018年6月在本院接受手术治疗的240例胸腰椎段脊柱骨折患者作为研究对象,按照患者选择手术方式的不同将其分为对照组和观察组,每组120例。对照组给予开放椎弓根钉内固定,观察组给予经皮椎弓根钉微创手术。观察两组临床疗效,术后随访观察两组并发症发生情况,采用健康调查简表(SF-36)对两组患者治疗前后生活质量评分进行评估。结果:观察组临床治疗总有效率为95.00%(114/120),对照组为76.67%(92/120),两组比较差异有统计学意义(P<0.05)。观察组术后运动障碍、肌肉萎缩、切口感染、椎体塌陷发生率均低于对照组(P<0.05)。两组治疗前生活质量评分比较,差异均无统计学意义(P>0.05);观察组治疗后其他七项评分均高于对照组,BP评分低于对照组,差异均有统计学意义(P<0.05)。结论:与开放椎弓根钉内固定手术比较,经皮椎弓根钉微创治疗胸腰椎段脊柱骨折患者,临床治疗效果更佳,患者术后并发症发生率低,且术后生活质量恢复更好,具有更好的安全性,值得在临床上优先采用。

Objective:To compare the clinical effect of minimally invasive percutaneous pedicle screw and open pedicle screw fixation in the treatment of thoracolumbar vertebral fracture and the impact on the quality of life of patients.Method:A total of 240 patients with thoracolumbar vertebral fracture treated in our hospital from June 2010 to June 2018 were selected as the research objects,the patients were divided into the control group and the observation group,120 cases in each group.Patients in the control group were treated with open pedicle screw fixation,and patients in the observation group were treated with minimally invasive percutaneous pedicle screw fixation.The clinical efficacy of two groups of patients was observed,postoperative follow-up was conducted to observe the incidence of complications in two groups,and the changes of quality of life scores in two groups were evaluated by using the health survey summary table(SF-36).Result:The total effective rate of clinical treatment of the observation group was 95.00%(114/120),the control group was 76.67%(92/120),the difference between two groups was statistically significant(P<0.05).The incidences of postoperative movement disorders,muscle atrophy,incision infection and vertebral collapse complications in the observation group were lower than those in the control group,there were statistical significance(P<0.05).There were no significant differences in quality of life scores between two groups before treatment(P>0.05).After treatment,the scores of the other seven items in the observation group were all higher than those in the control group,while the BP score in the observation group was lower than that in the control group,there were statistical significance(P<0.05).Conclusion:Compared with open pedicle screw fixation,minimally invasive percutaneous pedicle screw fixation in the treatment of patients with thoracolumbar vertebral fracture has a better effect,the incidence of postoperative complications after followup is lower,and the postoperative quality of life of patients is better restored,it has better security,it is worthy of priority in clinical use.