经皮与开放椎弓根钉棒系统复位内固定治疗中青年单节段胸腰椎压缩性骨折临床疗效比较

Clinical curative effect comparison of patients with single segmental thoracolumbar compression fractures in middle-aged and young treat with reduction and internal fixation by percutaneous pedicle screw rod system

目的研究采用经皮椎弓根钉棒系统复位内固定与后路切开椎弓根钉棒系统内固定治疗中青年单节段胸腰椎压缩骨折的疗效。方法将2013年12月至2016年4月在我院腰椎压缩骨折行经皮椎弓根钉棒系统复位内固定与后路切开椎弓根钉棒系统内固定的70例中青年患者作为研究对象,其中35例采用经皮椎弓根钉棒系统复位内固定(经皮组),35例采用后路切开椎弓根钉棒系统内固定(开放组)。对手术时间,术中出血量,患者平均住院时间,患者治疗后6周视觉模拟疼痛(VAS)评分、Cobb角变化进行统计分析。结果两组均复位满意,术后6周和12周Cobb角变化两组差异无统计学意义(P>0.05),经皮组手术时间[(30±10.31)min vs.(95.2±12.1)min]、术中出血量[(20±22.36)ml vs.(200.3±13.4)ml]、平均住院时间[(5±2.1)d vs.(9±3.2)d]明显优于开放组(P<0.05),术后VAS评分明显低于开放组,差异有统计学意义(P<0.05)。结论对于单节段胸腰椎压缩性骨折采用经皮椎弓根钉棒系统复位内固定创伤小,出血少、住院时间短、术后恢复快,可取得满意的临床疗效。

Objective To compare the clinical efficacy of percutaneous pedicle screw fixation system in the treatment of thoracolumbar vertebral compression fractures in young adults with single segmental thoracic and lumbar vertebral compression fractures treated by internal fixation with percutaneous pedicle screw fixation and posterior approach. Methods 70 cases of thoracic and lumbar vertebral compression fractures were treated by the above two methods, 35 cases were treated by percutaneous group, 35 cases were treated by open group. Results The two groups had satisfactory reduction after 6 weeks and 12 weeks, the changes of Cobb angle difference between the two groups had no statistical significance(P>0.05); but the operation time, intraoperative bleeding volume, postoperative VAS score, the average hospitalization time of percutaneous group was significantly better than the open group(P<0.05). Conclusion For 35 cases of thoracolumbar vertebral compression fracture with percutaneous pedicle screw rod system, fixation operation time is short, with less trauma, fast recovery, can achieve satisfactory clinical efficacy.