经皮微创脊柱椎弓根钉棒内固定治疗对无神经损伤胸腰椎骨折患者关节功能、Cobb角及疼痛强度的影响

Effects of Percutaneous Minimally Invasive Spinal Pedicle Screw Rod Internal Fixation on Joint Function,Cobb Angle and Pain Intensity in Patients with Thoracolumbar Fractures without Nerve Injury

目的:探讨经皮微创脊柱椎弓根钉棒内固定治疗对无神经损伤胸腰椎骨折患者关节功能、Cobb角及疼痛强度的影响。方法:回顾性分析2018年1月-2019年12月新余袁河医院收治的无神经损伤胸腰椎骨折患者80例的临床资料。按照手术方法将其分为对照组39例与研究组41例。对照组行常规手术(切开椎弓根内固定)治疗,研究组行经皮微创脊柱椎弓根钉棒内固定治疗。比较两组的关节功能评分、伤椎后凸Cobb角、伤椎前缘高度比值、伤椎后缘高度比值、疼痛强度。结果:术后3个月两组Oswestry功能障碍指数(ODI)均低于术前(P<0.05),Harris评分均高于术前(P<0.05),且术后3个月研究组ODI低于对照组(P<0.05),Harris评分高于对照组(P<0.05)。术后3个月两组伤椎后凸Cobb角均小于术前(P<0.05),伤椎前缘高度比值、伤椎后缘高度比值均高于术前(P<0.05),且术后3个月研究组伤椎后凸Cobb角小于对照组(P<0.05),伤椎前缘高度比值、伤椎后缘高度比值均高于对照组(P<0.05)。术后3个月两组疼痛评分均低于术前(P<0.05),且术后3个月研究组疼痛评分低于对照组(P<0.05)。结论:采用经皮微创脊柱椎弓根钉棒内固定治疗无神经损伤胸腰椎骨折,能显著改善患者脊柱功能、髋关节功能,复位伤椎,减轻疼痛。

Objective:To investigate the effects of percutaneous minimally invasive spinal pedicle screw rod internal fixation on joint function,Cobb angle and pain intensity in patients with thoracolumbar fractures without nerve injury.Method:The clinical data of 80 patients with thoracolumbar fractures without nerve injury admitted to Xinyu Yuanhe Hospital from January 2018 to December 2019 were retrospectively analyzed.They were divided into the control group(39 cases)and the study group(41 cases)according to the operation methods.The control group was treated with conventional surgery(open pedicle internal fixation),and the study group was treated with percutaneous minimally invasive spinal pedicle screw rod internal fixation.The joint function score,Cobb angle of kyphosis,ratio of anterior edge height of injured vertebra,the ratio of posterior edge height of injured vertebra and pain intensity were compared between the two groups.Result:At 3 months after operation,the Oswestry dysfunction index(ODI)in both groups were lower than those before operation(P<0.05),Harris scores were higher than those before operation(P<0.05),ODI of study group was lower than that of control group(P<0.05),Harris score of study group was higher than that of control group(P<0.05).At 3 months after operation,the Cobb angle of kyphosis in the two groups were smaller than those before operation(P<0.05),the ratio of anterior edge height of injured vertebra and the ratio of posterior edge height of injured vertebra were higher than those before operation(P<0.05),and the Cobb angle of kyphosis in the study group was smaller than that in the control group(P<0.05),and the ratio of anterior edge height of injured vertebra and the ratio of posterior edge height of injured vertebra in the study group were higher than those of the control group(P<0.05).At 3 months after operation,the pain score of the two groups were lower than those before operation(P<0.05),and the pain score of the study group was lower than that of the control group(P<0.05).Conclusion:Percutaneous minimally invasive spinal pedicle screw rod internal fixation for thoracolumbar fractures without nerve injury can significantly improve the spinal function and hip joint function of patients,reduce the injured vertebra and relieve pain.