经伤椎置钉经皮椎弓根螺钉系统治疗胸腰段椎体骨折的疗效

Evaluation of the Effect of Percutaneous Pedicle Screw System in the Treatment of Thoracolumbar Vertebral Fracture

目的:对比分析经皮椎弓根螺钉内固定治疗胸腰段骨折经伤椎置钉与跨伤椎置钉的疗效。方法:收集2019年1月~2021年12月经本院行经皮椎弓根螺钉内固定治疗的单纯胸腰段骨折患者54例,按是否经伤椎置钉分为观察组(经伤椎置钉)、对照组(跨伤椎置钉)。结果:术后3d、6个月,两组疼痛程度、功能障碍、Cobb角、伤椎前缘高度恢复率均较术前明显改善(P<0.05);术后3d,两组疼痛程度、功能障碍、伤椎前缘高度恢复率组间比较差异无统计学意义(P>0.05),观察组Cobb角均明显小于对照组(P<0.05);术后6个月观察组功能障碍、Cobb角、伤椎前缘高度恢复率均明显优于对照组(P<0.05)。经伤椎双侧置钉与经伤椎单侧置钉治疗不同时间点组间比较无明显差异(P>0.05)。结论:经皮椎弓根螺钉内固定治疗单纯胸腰段骨折的过程中经伤椎置钉可以更好地恢复及保持患椎AH、Cobb角,维持脊柱生理曲度,避免椎体高度丢失等问题的出现,效果确切。

Objective:To compare and analyze the efficacy of percutaneous pedicle screw internal fixation in the treatment of thoracolumbar fractures with and without vertebral fixation.Methods:A total of 54 patients with simple thoracolumbar fractures who underwent percutaneous pedicle screw internal fixation treatment in our hospital from January 2019 to December 2021 were collected.They were divided into an observation group(percutaneous pedicle screw placement)and a control group(percutaneous pedicle screw placement)based on whether or not they underwent pedicle screw placement.Results:At 3 days and 6 months after surgery,the recovery rates of pain severity,functional impairment,Cobb angle,and anterior edge height of the injured vertebra in both groups were significantly improved compared to before surgery(P<0.05);Three days after surgery,there was no statistically significant difference in the degree of pain,dysfunction,and recovery rate of anterior edge height between the two groups(P>0.05).The Cobb angle in the observation group was significantly lower than that in the control group(P<0.05);The recovery rate of dysfunction,Cobb angle,and anterior edge height of the injured vertebra in the observation group was significantly better than that in the control group at 6 months after surgery(P<0.05).There was no significant difference(P>0.05)between the two groups at different time points for the treatment of bilateral nail placement and unilateral nail placement in the injured vertebra.Conclusion:Percutaneous pedicle screw fixation for the treatment of simple thoracolumbar fractures can better restore and maintain the AH and Cobb angles of the affected vertebrae,maintain the physiological curvature of the spine,and avoid the occurrence of issues such as vertebral height loss.The effect is accurate.