经皮与开放椎弓根钉内固定对86例胸腰椎骨折患者的治疗效果对比研究

A Comparative Study on the Therapeutic Effect of Percutaneous and Open Pedicle Screw Internal Fixation in 86 Patients with Thoracolumbar Fracture

目的:探究在胸腰椎骨折患者中采用经皮椎弓根内固定术与开放椎弓根内固定术的临床疗效,并对其进行探讨与分析。方法:选取我院骨科2017年1月-2021年1月治疗的胸腰椎骨折患者86例作为研究对象,根据随机数字表法将86例胸腰椎骨折患者分为对照组和观察组。对照组(43例)给予开放椎弓根内固定术治疗,观察组(43例)给予经皮椎弓根内固定术治疗,对比2组患者的并发症发生率、手术指标、伤椎椎体前缘高度、椎间隙高度及Cobb角以及视觉模拟评分法(visual analogue scales,VAS)评分。结果:观察组并发症发生率低于对照组,2组差异具有统计学意义(P<0.05);观察组切口长度、手术时间及术后引流量均少于对照组,2组手术指标差异具有统计学意义(P<0.05);观察组伤椎椎体前缘高度、椎间隙高度均大于对照组,2组差异具有统计学意义(P<0.05);观察组Cobb角小于对照组,2组差异具有统计学意义(P<0.05);观察组VAS评分低于对照组,2组差异具有统计学意义(P<0.05)。结论:在胸腰椎骨折患者中采用经皮椎弓根内固定术可降低胸腰椎骨折患者的并发症发生率,改善手术指标,增大伤椎椎体前缘高度、椎间隙高度,缩小Cobb角,缓解疼痛感。

Objective:To explore the clinical effects of percutaneous pedicle internal fixation and open pedicle internal fixation in patients with thoracolumbar fractures,and to discuss and analyze them.Methods:86 patients with thoracolumbar fractures who were treated in the orthopedics department of our hospital from January 2017 to January 2021 were selected as the study subjects.According to the method of random number table,86 patients with thoracolumbar fractures were divided into control group and observation group.43 patients with thoracolumbar fractures in the control group were treated with open pedicle internal fixation,and 43 patients with thoracolumbar fractures in the observation group were treated with percutaneous pedicle internal fixation.The incidence of complications,surgical indicators,the height of the anterior edge of the injured vertebral body,the height of the intervertebral space,the Cobb angle,and the visual analog scale(VAS)scores were compared between the two groups.Results:The complication rate of 43 patients with thoracolumbar fracture in the observation group was lower than that of 43 patients with thoracolumbar fracture in the control group,and the difference between the two groups was statistically significant(P<0.05);The incision length,operation time and postoperative drainage volume of 43 patients with thoracolumbar spine fracture in the observation group were less than those of 43 patients with thoracolumbar spine fracture in the control group.The difference between the two groups was statistically significant(P<0.05).The height of the anterior edge of the injured vertebral body and the height of the intervertebral space of the 43 patients with thoracolumbar fracture in the observation group were higher than those of the 43 patients with thoracolumbar fracture in the control group.The difference between the height of the anterior edge of the injured vertebral body and the height of the intervertebral space of the two groups was statistically significant(P<0.05);The Cobb angle of 43 patients with thoracolumbar fracture in the observation group was smaller than that of 43 patients with thoracolumbar fracture in the control group,and the difference between the two groups was statistically significant(P<0.05).The VAS score of 43 patients with thoracolumbar fractures in the observation group was lower than that of 43 patients with thoracolumbar fractures in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Percutaneous pedicle intermnal fixation in patients with thoracolumbar fractures can reduce the incidence of complications in patients with thoracolumbar fractures,improve the surgical indicators of patients with thoracolumbar fractures,increase the height of the anterior edge of the injured vertebral body and the height of the intervertebral space,reduce the Cobb angle,and relieve the pain of patients with thoracolumbar fractures.