经伤椎植入万向螺钉对胸腰椎骨折患者伤椎恢复的影响

The Effect of Implanting Polyaxial Screws Through the Injured Vertebra on the Recovery of the Injured Vertebra in Patients with Thoracolumbar Vertebral Fractures

目的:探讨与分析经伤椎植入万向螺钉对胸腰椎骨折患者伤椎恢复的影响。方法:选取医院2019年1月~2023年11月收治的76例胸腰椎骨折患者作为研究对象,所有患者的手术与麻醉均由同一组完成。根据1:1随机数字表法将76例患者分为万向组38例与对照组38例。记录两组的伤椎恢复情况。结果:所有患者均顺利完成手术,围手术期无发生严重并发症,万向组与对照组手术时间、术后引流量、术中出血量对比无明显差异(P>0.05),但是万向组的术后住院天数与对照组相比显著降低(P<0.05)。两组术后3个月的Cobb角、伤椎压缩率都显著低于术前1d(P<0.05),万向组术后3个月的Cobb角、伤椎压缩率与对照组相比降低更多(P<0.05)。两组术后3个月的伤椎相邻上位椎间隙高度、伤椎相邻下位椎间隙高度都显著低于术前1d(P<0.05),万向组术后3个月的伤椎相邻上位椎间隙高度、伤椎相邻下位椎间隙高度与对照组相比显著降低(P<0.05)。结论:经伤椎植入万向螺钉在胸腰椎骨折患者的应用能降低患者的Cobb角、伤椎压缩率,可取得良好的治疗效果。

Objective:To explore and analyze the effect of implanting polyaxial screws through the injured vertebra on the recovery of the injured vertebra in patients with thoracolumbar vertebral fractures.Methods:76 patients with thoracolumbar vertebral fractures admitted to the hospital from January 2019 to November 2023 were selected as the research subjects.All patients underwent surgery and anesthesia by the same group of physicians.According to the 1:1 random number table method,76 cases were divided into a polyaxial group of 38 cases and a control group of 38 cases.The recovery status of the injured vertebrae in both groups were recorded.Results:All patients successfully completed the surgery without any serious complications during the perioperative period.There was no significant difference in surgical time,postoperative drainage volume,and intraoperative bleeding between the polyaxial group and the control group(P>0.05).The postoperative hospitalization days of the polyaxial group were significantly reduced compared to the control group(P<0.05).The Cobb angle and vertebral compression rate of both groups were significantly lower at 3 months post surgery than at 1 day before surgery(P<0.05).The Cobb angle and vertebral compression rate of the polyaxial group decreased significantly compared to the control group at 3 months after surgery(P<0.05).The height of the adjacent upper intervertebral space and the adjacent lower intervertebral space of the injured vertebra in both groups at 3 months after surgery were significantly lower than those on the 1st day before surgery(P<0.05).The height of the adjacent upper and lower intervertebral spaces of the injured vertebra in the polyaxial group was significantly reduced compared to the control group at 3 months after surgery(P<0.05).Conclusion:The application of implanting polyaxial screws through the injured vertebra in patients with thoracolumbar vertebral fractures can reduce the Cobb angle and vertebral compression rate,and achieve good therapeutic effects.