经皮与椎旁肌间隙入路椎弓根螺钉内固定对腰椎骨折患者腰椎功能、伤椎椎体前缘高度比及隐性失血量的影响

Effects of percutaneous and paraspinal muscle approach pedicle screw internal fixation on lumbar spine function,anterior height ratio of injured vertebrae and hidden blood loss in patients with lumbar fractures

目的探讨经皮与椎旁肌间隙入路椎弓根螺钉内固定对腰椎骨折患者腰椎功能、伤椎椎体前缘高度比及隐性失血量的影响。方法选取2019年6月至2020年6月收治的40例腰椎骨折患者作为研究对象,以抽签法随机将其分为A组(20例,经皮椎弓根螺钉内固定)和B组(20例,经椎旁肌间隙入路椎弓根螺钉内固定)。比较两组的手术效果。结果术后1周,A组的VAS、ODI评分低于B组(P<0.05)。术后1周,A组的CRP、E、Cor水平低于B组(P<0.05)。术后1周、3个月,两组的伤椎椎体前缘高度比均增大,后凸Cobb角均减小(P<0.05),但组间比较,差异无统计学意义(P>0.05)。A组的切口长度小于B组,手术时间长于B组,可见出血量少于B组,隐性失血量多于B组,住院时间短于B组(P<0.05)。结论经皮与椎旁肌间隙入路椎弓根螺钉内固定治疗腰椎骨折均具有良好的效果,前者创伤更小,应激反应更小,可见出血量更少,术后腰椎功能恢复更快,后者手术时间更短,隐性失血量更少,临床应用时可根据实际情况选择。

Objective To explore the effects of percutaneous and paraspinal muscle approach pedicle screw internal fixation on lumbar spine function,anterior height ratio of injured vertebrae and hidden blood loss in patients with lumbar fractures.Methods A total of 40 patients with lumbar fractures admitted from June 2019 to June 2020 were selected as the research objects and randomly divided into group A(20 cases,percutaneous pedicle screw internal fixation)and group B(20 cases,paraspinal muscle approach pedicle screw internal fixation)by lottery.The operation effects of the two groups were compared.Results One week after operation,the VAS and ODI scores in the group A were lower than those in the group B(P<0.05).One week after operation,the levels of CRP,E and Cor in the group A were lower than those in the group B(P<0.05).At 1 week and 3 months after operation,the anterior height ratio of injured vertebrae in the two groups increased,and the Cobb angle of the kyphosis decreased(P<0.05),but there were no statistically significant differences between the two groups(P>0.05).The incision length in the group A was less than that in the group B,the operation time was longer than that in the group B,the visible blood loss was less than that in the group B,the hidden blood loss was more than that in the group B,and the hospitalization time was shorter than that in the group B(P<0.05).Conclusion Percutaneous and paraspinal muscle approach pedicle screw internal fixation has a good effect on lumbar fractures.The former has less trauma,less stress response,less visible blood loss,and faster recovery of lumbar spine function after operation,and the latter has shorter operation time and less hidden blood loss,and can be selected according to the actual situation in clinical application.