椎体强化短节段椎弓根螺钉固定治疗骨质疏松胸腰椎爆裂骨折患者效果观察

Observation on the effect of vertebral body augmentation reinforced with short-segment pedicle screw fixation in the treatment of osteoporotic thoracolumbar burst fractures

目的:探讨分析椎体强化短节段椎弓根螺钉固定治疗骨质疏松胸腰椎爆裂骨折患者效果。方法:选取2018年9月至2020年10月收治的96例骨质疏松胸腰椎爆裂骨折患者分为A、B两组。A组给予椎体强化短节段椎弓根螺钉固定治疗,B组给予经皮椎体成形术治疗,比较两组患者围手术期手术指标,术前、术后1周及末次随访VAS评分、ODI指数、后凸Cobb角、椎体前缘和后缘压缩比,术后恢复指标。结果:A组患者手术时间、术中出血量及术中透视次数均高于B组患者(P<0.05);术前两组患者VAS评分及ODI指数无显著性差异(P>0.05),术后1周及末次随访A组患者VAS评分及ODI指数较B组患者均显著降低(P<0.05);术前两组患者后凸Cobb角、椎体前缘和后缘压缩比无显著性差异(P>0.05),术后1周及末次随访A组患者后凸Cobb角、椎体前缘和后缘压缩比均显著低于B组患者(P<0.05);A组患者疼痛缓解时间、下床活动时间、住院时间较B组显著缩短(P<0.05)。结论:椎体强化短节段椎弓根螺钉固定治疗骨质疏松性胸腰椎爆裂性骨折患者可显著缓解患者疼痛,纠正后凸畸形,恢复伤椎高度,缩短术后恢复的时间,提高患者对于治疗的满意度,但是延长了手术时间、增加了术中出血量和术中透视次数,因此在治疗过程中要采取有效的方法规避风险。

Objective:To discuss and analyze the effect of vertebral body augmentation reinforced with short-segment pedicle screw fixation in the treatment of osteoporotic thoracolumbar burst fractures.Methods:A total of 96 patients with osteoporotic thoracolumbar burst fractures admitted from January 2018 to October 2020 were chosen and divided into Group A and Group B.Group A were treated with augmentation reinforced with short-segment pedicle screw fixation,while Group B were treated with percutaneous vertebroplasty,with the perioperative surgical indicators,VAS scores,ODI indexes,Cobb angles of kyphosis,compression ratios of anterior vertebral bodies to posterior vertebral bodies before operation,1 week after operation and the last follow-up,and post-operative recovery indexes compared;Results:The operation time,intraoperative blood loss and the number of intraoperative fluoroscopy in Group A were longer,more significant and larger than those in Group B(P<0.05).There was no significant difference in VAS scores and ODI indexes between the two groups before operation(P>0.05).The VAS scores and ODI indexes of Group A were significantly lower than those of Group B 1 week after operation and at the last follow-up(P<0.05).Before surgery,there was no significant difference in kyphotic Cobb angles,and the compression ratios of anterior vertebral bodies to posterior vertebral bodies(P>0.05).The kyphotic Cobb angles,the compression ratios of anterior vertebral bodies to posterior vertebral bodies in Group A were significantly lower than those in group B(P<0.05).Pain relief time,time to get out of bed,and hospital stay in Group A were significantly shorter than those in Group B(P<0.05).Conclusion:The treatment of osteoporotic thoracolumbar burst fractures with Vertebral body augmentation reinforced with short-segment pedicle screw fixation can significantly relieve patients of pain,correct kyphosis,restore the height of the injured vertebrae,shorten the postoperative recovery time,and improve the patient’s satisfaction with the treatment.However,the operation time is prolonged and the amount of intraoperative blood loss and the number of intraoperative fluoroscopy are increased,so effective methods must be taken to avoid risks during the treatment process.