经皮微创与开放椎弓根钉内固定手术治疗胸腰椎骨折疗效分析

Efficacy Analysis of Percutaneous Minimally Invasive and Open Pedicle Screw Internal Fixation Surgery for Thoracolumbar Fractures

目的分析经皮微创椎弓根钉内固定术、开放椎弓根钉内固定术治疗胸腰椎骨折的临床疗效。方法将50例胸腰椎骨折患者随机分为对照组(25例,行经皮微创椎弓根钉内固定术)和观察组(25例,行开放椎弓根钉内固定手术);分析两组患者手术指标、胸腰椎功能恢复、术后并发症及疼痛情况。结果与对照组比较,观察组患者术中及术后出血量少,手术时间和住院时间少于对照组(均P<0.01);观察组患者治疗后椎体前缘高度及椎间隙平均高度恢复情况与对照组比较差异无统计学意义(P>0.05);观察组术后24 h及术后7 d内疼痛情况低于对照组(P<0.01),术后并发症发生率与对照组比较差异无统计学意义(P>0.05)。结论在胸腰椎骨折的临床治疗中,两组患者的临床疗效比较差异无统计学意义(P>0.05);经皮微创椎弓根内固定术在手术时间、出血量、住院时间及术后疼痛方面表现良好,临床价值高,建议在条件允许的情况下优先采取该手术方法治疗。

Objective To analyze the clinical efficacy of percutaneous minimally invasive pedicle screw internal fixation and open pedicle screw internal fixation in the treatment of thoracolumbar fractures.Method 50 patients with thoracolumbar fractures were divided into a control group and an observation group,with 25 cases in each group.Patients in the control group underwent open pedicle screw internal fixation,while patients in the observation group underwent minimally invasive percutaneous pedicle screw internal fixation.The thoracolumbar function recovery,postoperative complication incidence and pain of patients in two groups were analyzed.Results Compared with the control group,the patients in the observation group had less bleeding,shorter operation time and shorter hospitalization time(all P<0.01);The recovery of height of vertebral body front edge and height of average intervertebral space of patients in the observation group after treatment were no statistically significant difference in the control group(P>0.05);The incidence of postoperative complications and postoperative pain in the observation group were lower than those in the control group(P<0.01).The postoperative complication incidence in the observation group was no statistically significant difference in the control group(P>0.05).Conclusion In the clinical treatment of thoracolumbar fractures,there is no statistically significant difference in clinical efficacy between the two groups(P>0.05);Percutaneous minimally invasive pedicle internal fixation performs well in operating time,blood loss,hospitalization time,and postoperative pain,it has high clinical value.It is recommended that this surgical treatment be given priority when conditions permit.