经皮微创椎弓根螺钉内固定治疗胸腰椎骨折的临床效果观察

Clinical Efficacy of Percutaneous Minimally Invasive Pedicle Screw Internal Fixation in Treatment of Patients with Thoracolumbar Fractures

目的分析经皮微创椎弓根螺钉内固定治疗胸腰椎骨折的临床效果。方法回顾性分析2018年9月—2019年12月收治的109例胸腰椎骨折的临床资料,根据手术方式不同分为研究组55例和对照组54例,研究组给予经皮微创椎弓根螺钉内固定治疗,对照组给予开放椎弓根螺钉内固定治疗。两组术后1、3、6、12个月进行复查和随访,比较两组手术相关指标、疼痛视觉模拟评分(VAS)、Cobb角、压缩椎体前后缘高度以及术后并发症发生情况。结果研究组切口长度、手术时间、住院时间均短于对照组,术中出血量少于对照组(P<0.05)。术后1、3、6、12个月,两组VAS评分均呈现下降趋势,Cobb角均呈现上升趋势,其中研究组VAS评分及Cobb角均低于对照组(P<0.05)。术后1、3、6、12个月,两组压缩椎体前后缘高度均呈上升趋势,其中研究组高于对照组(P<0.05)。研究组并发症发生率低于对照组(P<0.05)。结论经皮微创椎弓根螺钉内固定对胸腰椎骨折的疗效显著,能减轻术后疼痛,有效恢复伤椎的结构和功能,且并发症发生率低。

Objective To analyze the clinical efficacy of percutaneous minimally invasive pedicle screw internal fixation in treatment of patients with thoracolumbar fractures.Methods Clinical data of 109 patients with thoracolumbar vertebral fractures admitted between September 2018 and December 2019 was retrospectively analyzed.The patients were divided into research group(n=55)and control group(n=54)according to different surgical methods.Research group was treated with percutaneous minimally invasive pedicle screw internal fixation,while control group was given open pedicle screw internal fixation.The two groups were reexamined and followed up after surgery for 1,3,6,and 12 months.Surgery-related indicators,visual analogue scale(VAS)score for pain,Cobb angle,height values of anterior and posterior edges of the compressed vertebral body,and incidence rate of postoperative complications were compared between two groups.Results Length of surgical incision,operative duration,length of stay and intraoperative volume of blood loss in research group were significantly shorter or less than that those in control group(P<0.05).After surgery for 1,3,6 and 12 months,VAS scores showed downward trend,while Cobb angle showed upward trend in two groups;VAS scores and Cobb angle in research group were significantly lower or smaller than those in control group(P<0.05).After surgery for 1,3,6 and 12 months,height values of anterior and posterior edges of the vertebral bodies showed upward trend in two groups,and the values were significantly higher in research group than those in control group(P<0.05).The incidence rate of complications in research group was significantly lower than that in control group(P<0.05).Conclusion Percutaneous minimally invasive pedicle screw internal fixation may achieve significantly clinical efficacy in treatment of patients with thoracolumbar fractures,and it may relieve postoperative pain,effectively restore the structure and function of the injured vertebrae with low incidence rate of complications.