后路椎板减压螺钉置入术与椎管减压固定术治疗胸髓损伤对比研究

A Comparative Study of Posterior Spinal Surgery and Spinal Canal Decompression and Fixation in Patients with Thoracic Spinal Cord Injury

目的:探究后路椎板减压螺钉置入术与椎管减压固定术对胸髓损伤患者临床效果。方法:择取胸髓损伤患者54例,通过随机数字表法分为对照组27例,研究组27例。对照组采用后路椎板减压螺钉置入术,研究组采用椎管减压固定术治疗。统计两组患者相关手术指标情况;检测血清炎性因子水平;通过视觉模拟评分法(VAS)及Oswestry功能障碍指数(ODI)对两组患者疼痛程度及功能障碍程度进行评价;采用Frankel分级评估患者的脊髓损伤情况,对比两组术后效果。结果:术后与对照组相比,研究组手术时间、术中出血量、手术切口及住院时间均减少,具有统计学差异(均P<0.05)。术后1、3个月,与对照组相比,研究组白介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、VAS、ODI评分下降程度更为显著,Frankel分级情况上升程度更为显著,具有统计学差异(均P<0.05)。与对照组相比,研究组临床疗效更为显著,具有统计学差异(P<0.05)。结论:对胸髓损伤患者行椎管减压固定术的治疗效果较好,治疗后患者炎症水平降低,疼痛得到缓解,运动功能和神经功能得到恢复,整体疗效显著,值得临床推广。

Objective:To explore the clinical effect of posterior decompression screw and spinal canal decompression fixation on patients with thoracic spinal cord injury.Methods:A total of 54 patients with thoracic pulp injury were selected and divided into control group(27 cases)and study group(27 cases)by random number table method.The control group was treated with posterior decompression laminae screw,and the study group was treated with spinal canal decompression fixation.Relevant surgical indexes of the two groups were analyzed.Serum inflammatory factors were detected.Visual analog scale(VAS)and Oswestry Disability Index(ODI)were used to evaluate the degree of pain and dysfunction in the two groups.Frankel scale was used to evaluate the spinal cord injury of the patients,and the postoperative effects of the two groups were compared.Results:Compared with the control group,the operation time,intraoperative blood loss,surgical incision and hospital stay in the study group were reduced,with statistical differences(all P<0.05).1 and 3 months after surgery,compared with the control group,the decrease degree of interleukin1β(IL-1β),tumor necrosis factor-α(TNF-α),VAS and ODI scores in the study group was more significant,and the increase degree of Frankel grade was more significant,with statistical difference(all P<0.05).Compared with the control group,the clinical effect of the study group was more significant,with statistical difference(P<0.05).Conclusion:The treatment effect of spinal canal decompression and fixation for patients with thoracic spinal cord injury is good.After treatment,the inflammatory level of patients is reduced,pain is relieved,and motor function and nerve function are restored.The overall effect is significant,which is worthy of clinical promotion.