经皮椎弓根钉微创术治疗胸腰段脊柱骨折的效果和安全性

Efficacy and safety of percutaneous pedicle screw minimally invasive surgery on thoracolumbar spine fractures

目的探讨经皮椎弓根钉微创术治疗胸腰段脊柱骨折的效果和安全性。方法抽取2019年5月至2021年5月开封市中心医院收治的胸腰段脊柱骨折患者88例,按随机数字表法分为微创组和开放组,每组44例。开放组予以开放椎弓根钉内固定术,微创组予以经皮椎弓根钉微创术。比较两组恢复优良率、围术期情况、脊柱功能、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分及并发症发生情况。结果微创组恢复优良率(95.45%,42/44)高于开放组(79.55%,35/44),P<0.05;微创组切口长度、住院时间短于开放组,失血量少于开放组(P<0.05)。术后3个月,微创组椎体前缘相对高度、椎间隙高度与开放组比较差异未见统计学意义(P>0.05);术后3个月,微创组VAS、ODI评分均低于开放组(P均<0.05)。微创组并发症发生率(4.55%,2/44)低于开放组(18.18%,8/44),P<0.05。结论经皮椎弓根钉微创术治疗胸腰段脊柱骨折患者,可缩短手术切口,减少术中出血量,减轻腰椎功能障碍和疼痛度,改善腰椎功能,且手术安全性良好。

Objective To investigate the efficacy and safety of percutaneous pedicle screw minimally invasive surgery in the treatment of thoracolumbar spine fractures.Methods Eighty-eight patients with thoracolumbar spine fractures treated in Kaifeng Central Hospital from May 2019 to May 2021 were selected,and they were divided into minimally invasive group and open group by random number table method,with 44 cases in each group.The open group received open pedicle screw internal fixation,and the minimally invasive group received percutaneous pedicle screw minimally invasive surgery.The excellent and good rate of recovery,perioperative conditions,spinal function,visual analogue scale(VAS)score,Oswestry disability index(ODI)score,and complications were compared between the two groups.Results The excellent and good rate of recovery in the minimally invasive group was 95.45%(42/44),which was higher than 79.55%(35/44)in the open group(P<0.05).The incision length and hospital stay in the minimally invasive group were shorter than those in the open group,and the blood loss was less than that in the open group(P<0.05).There was no significant difference in the relative height of the anterior vertebral edge and the height of the intervertebral space between minimally invasive group and open group 3 months after operation(P>0.05).The VAS and ODI scores of the minimally invasive group were lower than those of the open group 3 months after operation(all P<0.05).The incidence of complications in the minimally invasive group was 4.55%(2/44),which was lower than 18.18%(8/44)in the open group(P<0.05).Conclusions Percutaneous pedicle screw minimally invasive surgery for patients with thoracolumbar spine fractures can shorten the surgical incision,reduce intraoperative blood loss,reduce lumbar spine dysfunction and pain,and promote the recovery of lumbar spine function,and the operation is safe.