后路经椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折的效果研究

Effect of Posterior Transpedicular Internal Fixation Combined with Vertebroplasty in the Treatment of Elderly Thoracolumbar Spine Fractures

目的评定老年胸腰段脊柱骨折患者使用后路经椎弓根内固定结合椎体成形术治疗的价值。方法选择枣庄市立医院在2020年5月—2021年5月期间接诊的82例老年胸腰段脊柱骨折患者,按照随机数表法分为对照组与观察组。对照组(n=41)给予短节段椎弓根钉内固定手术治疗,观察组(n=41)给予后路经椎弓根内固定结合椎体成形术治疗,将两组患者的治疗效果进行比较。结果观察组脊柱后凸Cobb’s角(4.23±0.56)°、椎体前缘高度压缩率(7.65±2.63)%、椎体后缘高度压缩率(1.75±0.22)%均小于对照组,差异有统计学意义(t=2.484、13.116、8.292,P<0.05);观察组不良反应发生率(4.88%)低于对照组,差异有统计学意义(χ^(2)=5.144,P=0.023);观察组VAS疼痛评分(2.06±0.42)分及ODI功能障碍指数(16.69±2.52)分均小于对照组,差异有统计学意义(t=11.235、5.407,P<0.05)。结论胸腰段脊柱骨折的老年患者采用后路经椎弓根内固定结合椎体成形术可以获得理想的治疗效果,有利于降低不良反应和疼痛感,并促进患者功能的恢复。

Objective To evaluate the value of posterior transpedicular fixation combined with vertebroplasty in elderly patients with thoracolumbar spine fractures.Methods A total of 82 elderly patients with thoracolumbar spine fractures admitted to Zaozhuang Municipal Hospital from May 2020 to May 2021 were selected and divided into control group and observation group according to the random number table method.The control group(n=41)was given short-segment pedicle screw internal fixation,and the observation group(n=41)was given posterior transpedicular internal fixation combined with vertebroplasty.The therapeutic effects of the two groups were compared.Results The Cobb’s angle of kyphosis in the observation group was(4.23±0.56)°,the anterior vertebral body height compression rate(7.65±2.63)%,and the vertebral body posterior height compression rate(1.75±0.22)%were lower than those in the control group,the difference was statistically significant(t=2.484,13.116,8.292,P<0.05);the incidence of adverse reactions in the observation group(4.88%)was lower than that in the control group,and the difference was statistically significant(X2=5.144,P=0.023);the VAS pain score(2.06±0.42)points,and the ODI dysfunction index(16.69±2.52)points of the observation group was lower than that of the control group,the difference was statistically significant(t=11.235,5.407,P<0.05).Conclusion Posterior transpedicular internal fixation combined with vertebroplasty for elderly patients with thoracolumbar spine fractures can achieve an ideal therapeutic effect,which is conducive to reducing adverse reactions and pain,and promoting functional recovery of patients.