Sextant微创经皮椎弓根螺钉内固定术对T10~L1脊柱骨折患者影像学指标、疼痛程度及椎体功能的影响

Effects of Sextant minimally invasive percutaneous pedicle screw fixation on imaging indicators,pain degree and vertebral function in patients with T10-L1 spinal fracture

目的 评估Sextant微创手术对T10~L1脊柱骨折患者影像学指标、疼痛程度和椎体功能的影响,为临床治疗提供科学依据。方法 回顾性分析2022年3月—2023年3月医院88例T10~L1脊柱骨折患者,观察组44例,使用Sextant微创经皮椎弓根螺钉内固定术,对照组44例,使用开放式椎弓根螺钉内固定术,比较2组影像学指标、疼痛程度及椎体功能。结果 观察组术后7 d影像学指标中椎体前缘高度[(1.49±0.10)cm]、椎体矢状面指数(SI)[(81.18±8.64)%]、伤椎后凸角[(9.73±1.03)°]、脊柱后凸角度(Cobb’s角)[(5.44±1.75)°]对比对照组[(1.43±0.12)cm、(74.06±7.79)%、(11.66±1.97)°、(7.82±2.05)°],差异有统计学意义(t=2.104、4.060、5.759、5.857,P均<0.001);观察组术后7 d的视觉模拟(VAS)评分[(2.73±0.51)分]与术后6个月的OSWESTRY功能障碍指数(ODI)[(15.91±2.27)分]、脊髓神经功能(JOA)[(11.23±1.35)分]对比对照组[(3.35±0.69)分、(19.64±2.32)分、(9.82±1.08)分],组间差异有统计学意义(t=4.793、7.623、5.410,P均<0.001)。结论 Sextant微创经皮椎弓根螺钉内固定术对脊柱骨折患者影像学指标具有改善作用,还能减轻患者疼痛程度,提升椎体功能。

Objective This study evaluated the effects of Sextant minimally invasive surgery on imaging indicators,degree of pain and vertebral function in patients with T10-L1 spinal fracture,to provide a scientific basis for clinical treatment.Methods A retrospective analysis was performed on 88 patients with T10-L1 spinal fracture in our hospital between March 2022 and March 2023.The observation group(44 cases) underwent Sextant minimally invasive percutaneous pedicle screw internal fixation,whereas the control group(44 cases) underwent open pedicle screw internal fixation.The imaging indexes,degree of pain and vertebral function were compared between groups.Results At 7 d,in the observation group,the imaging indicators of vertebral anterior margin height [(1.49±0.10) cm],vertebral sagittal plane index(SI) [(81.18±8.64)%],kyphotic angle [(9.73±1.03)°],and kyphotic angle(Cobb's angle) [(5.44±1.75)°] significantly differed from those in the control group [(1.43±0.12) cm,(74.06±7.79)%,(11.66±1.97)°,and(7.82±2.05)°,respectively](t=4.471,4.060,5.759,5.857,all P < 0.001).The visual analogue scale(VAS) score [(2.73±0.51)] at 7 days after surgery and OSWESTRY at 6 months after surgery in the observation group.In the observation group,the functional impairment index(ODI) [(15.91±2.27) points] and spinal cord function(JOA) [(11.23±1.35) points] significantly differed from those in the control group [(3.35±0.69) points(19.64±2.32) points,(9.82±1.08) points](t=4.793,7.623,5.410,all P < 0.001).Conclusion percutaneous pedicle screw fixation improved the imagingindexes of patients with spinal fracture,decreased the de-gree of pain and improved vertebral function.