不同手术入路对胸腰段脊柱骨折患者的疗效分析

Analysis of the Effects of Different Surgical Approaches on Patients with Thoracolumbar Spine Fractures

目的:对比不同手术入路对胸腰段脊柱骨折患者的疗效。方法:选择2018年7月-2021年6月在我院诊治胸腰段脊柱骨折患者108例,根据随机信封1:1抽签原则把患者分为观察组与对照组,各54例。观察组采用Wiltse入路行后路椎弓根钉棒复位固定,对照组采用正中小切口非融合手术。结果:观察组的术后住院天数、术后引流量、术中出血量与手术时间都少于对照组(P<0.05);观察组术后14天的切口感染、腰背疼痛、脑脊液漏等并发症发生率为1.9%,低于对照组的16.7%(P<0.05);2组术后1个月的伤椎前缘高度与后缘高度都高于术前(P<0.05),观察组高于对照组(P<0.05);观察组术后3个月的JOA评分优良率为98.1%,高于对照组的81.5%(P<0.05)。结论:Wiltse入路行后路椎弓根钉棒复位固定胸腰段脊柱骨折,能促进患者康复,减少术后并发症的发生,还可促进恢复患者伤椎前缘高度与后缘高度,改善关节功能。

Objective:To compare the effects of different surgical approaches on patients with thoracolumbar spine fractures.Methods:From July 2018 to June 2021,108 cases of patients with thoracolumbar spine fractures were selected for diagnosis and treatment in this hospital.The patients were divided into Wiltse group and control group with 54 cases each accorded to the random envelope 1:1 lottery principle.The Wiltse group used the Wiltse approach with posterior pedicle screw reduction and fixation,and the control group used the median and small incision non-fusion surgery.Results:The postoperative hospital stay,postoperative drainage,intraoperative blood loss and operation time in the Wiltse group were less than those in the control group(P<0.05).The incidence of complications such as incision infection,back pain,and cerebrospinal fluid leakage in the Wiltse group at 14 days after operation were 1.9%,which were lower than 16.7%in the control group(P<0.05).The height of the anterior edge and the height of the posterior edge of the injured vertebrae in the two groups were higher than that of the preoperative at one month after operation(P<0.05),and the Wiltse group were higher than the control group(P<0.05).The excellent and good rate of JOA score in the Wiltse group at three months after operation were 98.1%,which were higher than 81.5%in the control group(P<0.05).Conclusion:The Wiltse approach with posterior pedicle screw reduction and fixation of thoracolumbar spine fractures can promote the recovery of patients,reduce the occurrence of postoperative complications,and can also promote the restoration of the height of the anterior and posterior edges of the injured vertebrae,and improve the joints Function.