不同微创术式治疗胸腰段脊柱骨折的疗效比较

Comparison of different minimally invasive methods in the treatment of thoracolumbar spinal fractures

目的比较研究不同微创术式治疗胸腰段骨折的整体疗效。方法选取2019年1月至2020年12月本院收治的胸腰椎骨折患者共86例,治疗医师按照数字表法将86例患者分为两组。其中观察组43例,行微创经皮置入椎弓根钉固定治疗;对照组43例,行改良Wiltse入路椎弓根钉固定治疗。结果术后1天及4天,观察组患者的肌酸激酶同工酶水平均明显小于对照组(P<0.05);术后3天、7天,2组患者的VAS评分无明显差异(P>0.05);两组患者术后各时间点的后凸Cobb’s角及伤椎前缘高度值均无明显差异(P>0.05);术后3个月及术后半年,观察组的ODI评分均明显小于对照组(P<0.05)。结论微创经皮置钉固定术治疗胸腰段椎体骨折,患者术后的整体疗效更好。适合临床选择应用。

Objective To compare the overall efficacy of different minimally invasive methods in the treatment of thoracolumbar fractures.Methods 86 patients with thoracolumbar fractures treated in our hospital from January 2019 to December 2020 were selected.According to the digital table method,the treating physician divided 86 patients into two groups.43 cases in the observation group were treated with minimally invasive percutaneous pedicle screw fixation,and 43 cases in the control group were treated with modified Wiltse approach pedicle screw fixation.Results At 1 and 4 days after operation,the level of creatine kinase isoenzyme in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in VAS score between the two groups at 3 and 7 days after operation(P>0.05).There was no significant difference in the Cobb's angle of kyphosis and the height of anterior edge of injured vertebra between two groups at each time point after operation(P>0.05).At 3 months and half a year after operation,the ODI scores of the observation group were significantly lower than those of the control group(P<0.05).Conclusion Minimally invasive percutaneous screw fixation has a better overall effect for thoracolumbar vertebral fractures,and it is suitable for clinical application.