计算机导航经皮椎弓根钉内固定联合经伤椎椎弓根植骨治疗胸腰椎骨折疗效研究

Study on the currative effect of computer-guided percutaneous pedicle screw fixation combined with bone grafting through pedicle in the treatment of thoracolumbar fracture

目的分析计算机导航经皮置钉内固定术联合经伤椎椎弓根植骨治疗胸腰椎骨折的临床疗效。方法回顾性分析2019年9月至2021年12月该院收治的48例胸腰椎骨折患者的临床资料,其中24例进行计算机导航经皮椎弓根钉内固定联合经伤椎椎弓根植骨患者作为植骨组,24例单纯进行计算机导航经皮椎弓根钉内固定术患者作为非植骨组。比较2组患者手术时间、出血量,以及手术前后、末次随访时视觉模拟疼痛量表(VAS)及Oswestry功能障碍指数(ODI)评分、椎体前缘高度(AVH)、Cobb角等情况。2组患者均获随访12个月以上,且随访资料完整,末次随访时均已取出内植物。结果2组患者年龄、性别、住院时间,以及手术前后、末次随访时AVH、cobb角,手术前后VAS评分比较,差异均无统计学意义(P>0.05);2组患者出血量、手术时间,以及末次随访时VAS评分、AVH丢失比较,差异均有统计学意义(P<0.05)。结论计算机导航经皮椎弓根钉内固定联合经伤椎椎弓根植骨治疗胸腰椎骨折可很好地重建椎体高度,避免椎体高度丢失,且患者远期疼痛缓解更佳,具有一定的临床应用价值。

Objective To analyze the efficacy of computer-guided percutaneous pedicle screw fixation combined with injured vertebral bone grafting(PPSF+BG)through pedicle in the treatment of thoracolumbar fracture.Methods The data were analyzed retrospectively of the 48 patients who undergone PPSF in the hospital from September 2019 to December 2021.Of them,24 underwent the computer-guided PPSF+BG,as the bone grafting group,and 24 by simple computer-guided PPSF,as the control group.The two groups were compared in terms of operation time,intraoperative blood loss,hospital stay,the Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI),the height of the injured vertebra(anterior and posterior)and Cobb angle.All of them were followed up for more than 12 months,and the data were complete,and the endoplants were removed at the last follow-up.Results There were no significant differences in age,gender,length of hospital stay,AVH,cobb Angle and VAS score before and after operation between the two groups(P>0.05).There were significant differences in blood loss,operation time,VAS score at last follow-up,AVH loss between the two groups(P<0.05).Conclusion Computer-guided PPSF+BG in the treatment of thoracolumbar fracture reconstruct the vertebral body height very well,avoid the loss of vertebral height,and relieve the long-term pain of patients better,which had certain clinical value.