经皮入路长臂单轴椎弓根螺钉内固定手术在创伤性胸腰椎骨折患者中的应用

Application of Long-Arm Single-Axis Pedicle Screw Internal Fixation Surgery by Percutaneous Approach in Patients with Traumatic Thoracolumbar Fracture

目的:探讨经皮入路长臂单轴椎弓根螺钉内固定手术在创伤性胸腰椎骨折患者中的应用价值。方法:选择2021年1月—2023年12月山东省第一康复医院收治的94例创伤性胸腰椎骨折患者作为研究对象,采用随机数字表法将其分为对照组和研究组,各47例。对照组采用单平面椎弓根螺钉内固定手术治疗,研究组采用经皮入路长臂单轴椎弓根螺钉内固定手术治疗。比较两组围手术期一般情况、术后恢复情况、并发症发生情况、疼痛情况及伤椎复位情况。结果:研究组手术用时及住院时间均短于对照组,术中失血量低于对照组,差异均有统计学意义(P<0.05)。术后1周,研究组疼痛程度评分均低于对照组,差异有统计学意义(P<0.05)。术后1个月,研究组Cobb角及功能障碍情况均优于对照组,椎前缘高度及伤椎后缘高度均大于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为8.51%,相较于对照组的2.13%,差异无统计学意义(P>0.05)。结论:创伤性胸腰椎骨折患者采用经皮入路置入长臂单轴椎弓根螺钉的内固定术,有助于缩短手术用时及住院时间,减少术中出血量,有效降低疼痛程度、改善伤椎复位情况,利于术后恢复。

Objective:To investigate the value of long-arm single-axis pedicle screw internal fixation surgery by percutaneous approach in patients with traumatic thoracolumbar fracture.Methods:A total of 94 patients with traumatic thoracolumbar fractur admitted to the Shandong First Rehabilitation Hospital from January 2021 to December 2023 were selected as the study objects.They were divided into a control group and a study group by random number table method,with 47 cases in each group.The control group underwent conventional internal fixation surgery,the study group underwent long-arm single-axis pedicle screw internal fixation surgery by percutaneous approach.The general conditions,postoperative recovery,complications,pain and reduction of injured vertebrae were compared between the two groups.Results:The operation time and hospitalization time of the study group were shorter than that of the control group,the intraoperative blood loss was lower than that of the control group,with statistical significance(P<0.05).One week after surgery,the pain degree score of the study group was lower than that of the control group,the difference was statistically significant(P<0.05).One month after surgery,the Cobb angle and dysfunction of the study group were better than those of the control group,the height of the anterior vertebra and posterior edge of the injured vertebra were higher than those of the control group,with statistical significance(P<0.05).The incidence of complications in the study group was 8.51%,compared with 2.13%in the control group,with no statistical significance(P>0.05).Conclusion:The use of percutaneous pedicle screw insertion in patients with traumatic thoracolumbar fracture is helpful to shorten the operation time and hospital stay,reduce the amount of intraoperative blood loss,effectively reduce the degree of pain,improve the reduction of the injured vertebra,and facilitate postoperative recovery.