经椎旁肌间隙入路结合伤椎置钉内固定系统对胸腰椎骨折的治疗效果及对患者椎体前缘高度和伤椎楔变指数的影响

The therapeutic effect of using a paraspinal muscle interspace approach combined with an internal fixation system for thoracic and lumbar vertebral fractures and its impact on the anterior vertebral height and vertebral wedge index of the injured vertebra in patients

目的探讨经椎旁肌间隙入路结合伤椎置钉内固定系统对胸腰椎骨折的治疗效果及对患者椎体前缘高度和伤椎楔变指数的影响。方法选取2019年1月至2022年1月海东市平安区中医院收治的56例胸腰椎骨折患者作为研究对象,根据手术方式分为A组与B组,每组28例。A组采用经椎旁肌间隙入路结合伤椎双侧置钉内固定治疗,B组采用经椎旁肌间隙入路跨伤椎常规置钉治疗,比较两组基本手术指标、脊柱功能恢复情况、并发症发生情况、生命质量。结果A组下床活动及骨折愈合时间短于B组(P<0.05);两组术中出血量比较差异无统计学意义;术后3个月,两组椎体前缘高度、IVW均高于术前,Cobb角、ODI评分均低于术前,且A组椎体前缘高度、IVW高于B组,Cobb角、ODI评分均低于B组,差异有统计学意义(P<0.05)。A组并发症发生率低于B组,差异有统计学意义(P<0.05)。术后3个月,两组生理机能、生理职能、情感职能、精神健康、生命活力、社会功能、躯体疼痛、总体健康评分均高于术前,且A组均高于B组,差异有统计学意义(P<0.05)。结论经椎旁肌间隙入路结合伤椎双侧置钉内固定治疗胸腰椎骨折患者疗效显著,可有效改善患者脊柱功能,提高患者生命质量,减少并发症,值得临床推广应用。

Objective To explore the therapeutic effect of trans-paraspinal muscle space approach combined with internal fixation system for thoracolumbar fractures and its influence on the height of the anterior edge of vertebral body and wedge index of injured vertebral body.Methods 56 patients with thoracolumbar fractures admitted to Ping'an District Hospital of Traditional Chinese Medicine in Haidong City from January 2019 to January 2022 were selected as the research subjects,and they were divided into the group A and the group B according to the operation methods,with 28 cases in each group.Group A was treated with bilateral fixation of injured vertebra through paraspinal space approach,while group B was treated with conventional fixation of injured vertebra through paraspinal space approach.The basic surgical indexes,spinal function recovery,complications and quality of life were compared between the two groups.Results The time of getting out of bed and fracture healing in the group A was shorter than that in the group B(P<0.05);there was no significant difference in intraoperative bleeding between the two groups.3 months after operation,the height and IVW of the anterior vertebral body of the two groups were higher than those before operation,while the Cobb angle and ODI score were lower than those before operation,the height and IVW of the anterior vertebral body in the group A were higher than those in the group B,and the Cobb angle and ODI score were lower than those in group B,and the differences were statistically significant(P<0.05).The incidence of complications in group A was lower than that in group B,and the difference was statistically significant(P<0.05).3 months after operation,the scores of physiological function,physiological function,emotional function,mental health,vitality,social function,physical pain and overall health in the two groups were higher than those before operation,and the group A were higher than those in group B,and the differences were statistically significant(P<0.05).Conclusion Trans-paraspinal muscle space approach combined with bilateral internal fixation of injured vertebra is effective in the treatment of thoracolumbar fracture,which can effectively improve the spinal function,improve the quality of life and reduce complications,and is worthy of clinical promotion and application.