Sextant经皮微创脊柱内固定术与传统后路短节段椎弓根钉内固定治疗创伤性胸腰椎骨折的效果

Sextant Percutaneous Minimally Invasive Spinal Fixation and Traditional Posterior Short-segment Pedicle Screw Internal Fixation for the Treatment of Traumatic Thoracolumbar Fractures

目的:研究Sextant经皮微创脊柱内固定术与传统后路短节段椎弓根钉内固定治疗创伤性胸腰椎骨折的效果。方法:选取2019年1月-2020年12月本院90例创伤性胸腰椎骨折作为研究对象,以随机抽签方式分为对照组(45例)、试验组(45例),对照组进行传统后路短节段椎弓根钉内固定治疗,试验组进行Sextant经皮微创脊柱内固定术治疗,对比两组手术指标、术后恢复质量、炎性反应,以及并发症和不良预后发生率。结果:试验组手术时间、术中出血量及住院时间均优于对照组(P<0.05)。治疗前两组矢状面指数、后凸Cobb角、椎体前缘高度对比差异无统计学意义(P>0.05);治疗后试验组后凸Cobb角低于对照组,矢状面指数、椎体前缘高度高于对照组(P<0.05)。治疗前两组NSE、GFAP指标对比差异无统计学意义(P>0.05);治疗后试验组NSE、GFAP均低于对照组(P<0.05)。试验组感染、脑疝、重度残疾、植物生存发生率显著低于对照组(P<0.05)。结论:创伤性胸腰椎骨折使用Sextant经皮微创脊柱内固定术,与传统后路短节段椎弓根钉内固定治疗对比,可以更好地改善手术质量,促进术后各项功能的恢复,降低机体炎性指标,控制并发症及各种不良预后,提升治疗质量。

Objective:To study the effect of Sextant percutaneous minimally invasive spinal fixation and traditional posterior short-segment pedicle screw internal fixation for the treatment of traumatic thoracolumbar fractures.Method:From January 2019 to December 2020,90 cases of traumatic thoracolumbar vertebral fractures in our hospital were taken as the research objects.They were divided into the control group(45 cases)and the test group(45 cases)by random lottery.The control group was treated with traditional posterior short-segment pedicle screw internal fixation,and the test group was treated with Sextant percutaneous minimally invasive spinal internal fixation.The surgical indicators,postoperative recovery quality,inflammatory reactions,complications and adverse prognosis rate were compared between the two groups.Result:The operation time,intraoperative blood loss and hospitalization time of the test group were better than those of the control group(P<0.05).Before treatment,the sagittal plane index,kyphotic Cobb angle,and anterior edge height of the vertebral body were not different between the two groups(P>0.05),after treatment,the kyphotic Cobb angle of the test group was lower than that of the control group,and the sagittal plane index and anterior edge height of the vertebral body were higher than the control group(P<0.05).Before treatment,there were no difference in NSE and GFAP indexes between the two groups(P>0.05);after treatment,NSE and GFAP in the test group were lower than those in the control group(P<0.05).The incidence of infection,brain herniation,severe disability,and plant survival in the test group was significantly lower than that in the control group(P<0.05).Conclusion:The use of Sextant percutaneous minimally invasive spinal internal fixation for traumatic thoracolumbar fractures,compared with traditional posterior short-segment pedicle screw internal fixation,can better improve the quality of surgery and promote the recovery of various functions after surgery,reduce the body’s inflammatory indicators,control complications and various adverse prognosis,and improve the quality of treatment.