Sextant微创经皮椎弓根螺钉内固定术对胸腰椎多发脊柱骨折患者的影响

Effect of Sextant Minimally Invasive Percutaneous Pedicle Screw Fixation on Patients with Thoracolumbar Multiple Spinal Fractures

目的:探究Sextant微创经皮椎弓根螺钉内固定术对胸腰椎多发脊柱骨折患者的影响。方法:选择2021年5月—2023年5月江西嘉佑曙光骨科医院收治的96例胸腰椎多发脊柱骨折患者,按随机数字表法分两组,各48例。对照组行开放式椎弓根内固定术,观察组行Sextant微创经皮椎弓根螺钉内固定术。比较两组围手术期指标、疼痛程度、椎体功能、影像学指标、并发症、生活质量。结果:两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量、术后引流量均少于对照组,切口长度、住院时间均短于对照组,差异均有统计学意义(P<0.05)。术前,两组视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分、影像学指标、生活质量综合评定问卷(GQOLI-74)评分比较,差异均无统计学意义(P>0.05)。术后3个月,观察组VAS、ODI评分均低于对照组,GQOLI-74各维度评分均高于对照组,差异均有统计学意义(P<0.05)。术后7 d,观察组伤椎前缘高度比、椎体矢状面指数(SI)均高于对照组,脊柱后凸角度(Cobb角)小于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:相较于开放式手术,Sextant微创经皮椎弓根螺钉内固定术能够进一步减轻胸腰椎多发脊柱骨折患者的疼痛程度,改善影像学指标、椎体功能,减少并发症的发生,提高生活质量。

Objective:To explore the effect of Sextant minimally invasive percutaneous pedicle screw fixation on patients with thoracolumbar multiple spinal fractures.Method:A total of 96 patients with thoracolumbar multiple spinal fractures admitted to Jiangxi Jiayou Shuguang Orthopedic Hospital from May 2021 to May 2023 were selected and divided into two groups according to random number table method,with 48 cases in each group.The control group underwent open pedicle internal fixation,and the observation group underwent Sextant minimally invasive percutaneous pedicle screw fixation.Perioperative indexes,pain degree,vertebral function,imaging indexes,complications and quality of life between the two groups were compared.Result:There was no significant difference in surgery time between the two groups(P>0.05).The intraoperative blood loss and postoperative drainage volume in the observation group were less than those in the control group,and the incision length and hospital stay were shorter than those in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in visual analogue scale(VAS)score,Oswestry disability index(ODI)score,imaging index and generic quality of life inventory 74(GQOLI-74)score between the two groups(P>0.05).Three months after surgery,VAS and ODI scores in observation group were lower than those in control group,and the scores of GQOLI-74 in all dimensions were higher than those in control group,the differences were statistically significant(P<0.05).At 7 d after surgery,the frontal height ratio of injured vertebra and sagittal plane index(SI)of the observation group were higher than those of the control group,and the kyphotic angle(Cobb angle)was smaller than that of the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with open surgery,Sextant minimally invasive percutaneous pedicle screw fixation can further reduce the pain degree of patients with thoracolumbar multiple spinal fractures,improve imaging indicators,vertebral function,reduce the occurrence of complications,and improve quality of life.