经皮微创椎弓根螺钉内固定治疗创伤性脊柱骨折疗效观察

Observation on the Efficacy of Minimally Invasive Percutaneous Pedicle Screw Fixation in the Treatment of Traumatic Spinal Fractures

目的探讨经皮微创椎弓根螺钉内固定术治疗创伤性脊柱骨折的临床疗效。方法选取2019年4月至2020年1月鹤壁市人民医院收治的72例创伤性脊柱骨折患者作为研究对象,并按照治疗方法将其分为观察组与对照组,每组36例。观察组患者采用经皮微创椎弓根螺钉内固定术治疗,对照组患者采用开放式椎弓根螺钉内固定术治疗,对比观察两组患者手术时间、术中出血量、术后引流量、住院时间、并发症发生情况及椎体前缘高度、Cobb角与Oswestry功能障碍指数(ODI)评分变化情况。结果观察组患者手术时间、住院时间均短于对照组(t=15.304、18.129,P均<0.001),术中出血量、术后引流量均少于对照组(t=24.223、20.827,P均<0.001);术后6个月,观察组患者椎体前缘高度明显高于对照组,Cobb角明显小于对照组,ODI评分明显低于对照组(t=5.509、16.888、19.759,P均<0.001);观察组患者术后并发症发生率为5.56%,明显低于对照组患者的术后并发症发生率22.22%(χ^(2)=4.181,P=0.041)。结论与开放式椎弓根螺钉内固定术相比,经皮微创椎弓根螺钉内固定术可明显提高创伤性脊柱骨折患者的复位效果,缩短手术时间及住院时间,减少并发症的发生,临床应用价值更高。

Objective To study the clinical efficacy of minimally invasive percutaneous pedicle screw fixation in the treatment of traumatic spinal fractures.Methods 72 patients with traumatic spinal fractures admitted to the People’s Hospital of Hebi between April 2019 and January 2020,were enrolled and divided,according to the treatments they received,into observation group(n=36)and control group(n=36).Patients in observation group were treated with minimally invasive percutaneous pedicle screw fixation,whereas patients in control group with open pedicle screw fixation.Surgery time,blood loss during surgery,drainage volume after surgery,length of stay(LOS),complication incidence,anterior vertebral body height,Cobb angle and Oswestry Disability Index(ODI)score,were compared.Results Surgery time and LOS in observation group were shorter than control group(t=15.304 and 18.129,both P<0.001),and blood loss during surgery and drainage volume after surgery were less than control group(t=24.223 and 20.827,both P<0.001).6 months after surgery,anterior vertebral body height in observation group was significantly higher than control group,Cobb angle in observation group was significantly smaller than control group,and the ODI score in observation group was significantly lower than control group(t=5.509,16.888 and 19.759,all P<0.001).Complication incidence in observation group was5.56%,much lower than 22.22%in control group(χ^(2)=4.181,P=0.041).Conclusion Compared with open pedicle screw fixation,minimally invasive percutaneous pedicle screw fixation could effectively improve reduction of traumatic spinal fractures,shorten surgery time and LOS,and reduce incidence of complications.Therefore,it has a much higher clinical application value.