经椎弓根椎体内植骨联合短节段固定治疗老年脊柱骨折的效果观察

Effect of transpedicular bone grafting combined with short segment fixation in the treatment of spinal fractures in the elderly

目的探讨经椎弓根椎体内植骨联合短节段固定治疗老年脊柱骨折的临床效果。方法抽取2018年1月至2020年12月驻马店市第一人民医院收治的老年脊柱骨折患者78例,按照随机数字表法分为对照组和研究组,每组39例。对照组采用短节段固定术治疗,研究组在对照组基础上采用经椎弓根椎体内植骨治疗。比较两组围术期指标、视觉模拟评分表(VAS)评分、Oswestry功能障碍指数(ODI)评分、伤椎修复情况(椎体高度丢失量、Cobb角)及并发症发生率。结果两组手术时间、术中出血量、住院时间比较差异未见统计学意义(P>0.05);研究组术后6个月VAS评分、ODI评分低于对照组(P<0.05);研究组术后6个月椎体高度丢失量少于对照组、Cobb角小于对照组(P<0.05);研究组并发症发生率(10.26%,4/39)低于对照组(30.77%,12/39),差异有统计学意义(P<0.05)。结论经椎弓根椎体内植骨联合短节段固定应用于老年脊柱骨折中效果显著,能缓解机体疼痛,有效促进伤椎修复,改善患者脊椎功能,且术后不易发生内固定物松动和断裂等并发症。

Objective To investigate the effect of transpedicular bone grafting combined with short segment fixation in the treatment of spinal fractures in the elderly.Methods A total of 78 elderly patients with spinal fractures treated in the First People’s of Zhumadian from January 2018 to December 2020 were selected,and they were divided into control group and study group according to random number table method,with 39 cases in each group.The control group was treated by short segment fixation,and the study group was treated by transpedicular bone grafting based on the treatment of the control group.Perioperative indexes,visual analogue scale(VAS)score,Oswestry disability index(ODI)score,vertebral repair(vertebral height loss,Cobb angle)and incidence of complications of the two groups were compared.Results There was no significant difference in operation time,intraoperative blood loss and hospital stay between the two groups(P>0.05).The VAS score and ODI score of the study group were lower than those of the control group 6 months after operation(P<0.05).Six months after operation,the vertebral height loss and Cobb angle in the study group were less than those in the control group(P<0.05).The incidence of complications in the study group(10.26%,4/39)was lower than that in the control group(30.77%,12/39),and the difference was significant(P<0.05).Conclusions The application of transpedicular bone grafting combined with short segment fixation has significant effects in the treatment of spinal fractures in elderly patients,which can relieve body pain,effectively promote the repair of injured vertebrae,improve the spinal function of patients,with lower risk of complications,such as internal fixation loosening and fracture.