单纯经椎弓根复位内固定、经椎弓根内固定与椎体成形治疗胸腰椎爆裂性骨折的效果观察

Effects of simple transpedicular reduction and internal fixation, transpedicular screw fixation and vertebroplasty in the treatment of thoracolumbar burst fractures

目的:讨论单纯经椎弓根复位内固定、经椎弓根内固定与椎体成形治疗胸腰椎爆裂性骨折的效果。方法:回顾性分析120例胸腰椎爆裂性骨折患者为研究对象,按照治疗方式不同分为观察组(n=60)和对照组(n=60)。观察组采用经椎弓根内固定与椎体成形治疗;对照组采用单纯经椎弓根复位内固定。比较两组患者手术情况、脊柱功能障碍情况、影像学检查情况、术后并发症发生情况等。结果:研究组患者手术时间为(136.53±25.78)min,高于对照组的(84.46±4.57)min;术后住院时间为(16.48±6.43)d,低于对照组的(21.57±6.74)d,差异有统计学意义(P<0.05)。术后6个月时,两组患者VAS、ODI得分、椎体前缘压缩率、椎体后缘压缩率、Cobb角均较手术前下降,且研究组低于对照组(P<0.05);术后6个月,两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:经椎弓根内固定与椎体成形治疗胸腰椎爆裂性骨折更有利于患者术后恢复,对患者脊柱功能恢复效果更好,但会导致骨水泥渗漏。

Objective:To explore the effects of simple transpedicular reduction and internal fixation, transpedicular screw fixation and vertebroplasty in the treatment of thoracolumbar burst fractures.Methods:The clinical data of 120 patients with thoracolumbar burst fractures were retrospectively analyzed, and they were divided into the study group(n=60) and control group(n=60) according to the different treatment methods.The study group was treated with pedicle internal fixation and vertebroplasty, and the control group was treated with simple transpedicular reduction.The differences in surgical conditions, spinal dysfunction, imaging examination and occurrence of postoperative complications were compared between the two groups.Results:The operation time in the study group(136.53±25.78) min was higher than that in the control group(84.46±4.57) min, and the postoperative hospital stay(16.48±6.43) days was lower than that(21.57±6.74) days in the control group(P<0.05).At 6 months after surgery, the scores of VAS and ODI,anterior vertebral compression rate, posterior vertebral compression rate and Cobb angle of the two groups were all decreased compared with those before surgery, and the indicators in the study group were lower than those in the control group(P<0.05).There were no statistically significant differences in the occurrence of postoperative complications between the two groups within 6 months after surgery(P>0.05).Conclusion:Transpedicular screw fixation and vertebroplasty for the treatment of thoracolumbar burst fractures is more conducive to postoperative recovery of patients, and can have a better effect on the recovery of spinal function, but it will lead to leakage of bone cement.