经皮椎弓根钉内固定结合椎体成形术治疗中老年骨质疏松性单节段胸腰椎压缩性骨折的效果

目的分析经皮椎弓根钉内固定结合椎体成形术治疗中老年骨质疏松性单节段胸腰椎压缩性骨折的效果。方法选择我院2014年8月至2018年8月收治的225例中老年骨质疏松性单节段胸腰椎压缩性骨折患者为研究对象,根据治疗方法的不同将患者分为微创组(n=115)和开放组(n=110)。微创组给予经皮椎弓根钉内固定结合经皮椎体成形术,开放组给予传统开放椎弓根钉复位内固定术。比较两组手术相关指标、术前及术后5个月的VAS评分、ODI评分、伤椎前缘高度比及伤椎后凸Cobb角。结果两组患者均顺利完成手术。微创组的手术时间和住院时间短于开放组,术中出血量少于开放组,切口长度小于开放组,差异具有统计学意义(P<0.05)。术后5个月,两组患者的VAS评分、ODI评分及伤椎后凸Cobb角均降低,伤椎前缘高度比均升高(P<0.05);微创组术后5个月的VAS评分、ODI评分低于开放组(P<0.05)。结论经皮椎弓根钉内固定结合经皮椎体成形术治疗中老年骨质疏松性单节段胸腰椎压缩性骨折优势明显,可以减轻患者术后疼痛,促进伤椎功能的恢复。

Effect of percutaneous pedicle screw fixation combined with vertebroplasty in the treatment of middle-aged and elderly patients with osteoporotic single segment thoracolumbar compression fractures

Objective To analyze the effect of percutaneous pedicle screw fixation combined with vertebroplasty in the treatment of middle-aged and elderly patients with osteoporotic single segment thoracolumbar compression fractures.Methods Two hundred and twenty-five middle-aged and elderly patients with osteoporotic single segment thoracolumbar compression fracture admitted in our hospital from August 2014 to August 2018 were selected as the study objects.According to the different treatment methods,the patients were divided into minimally invasive group(n=115) and open group(n=110).The minimally invasive group was treated with percutaneous pedicle screw fixation combined with vertebroplasty,while the open group was treated with traditional open pedicle screw reduction and internal fixation.The operative indexes,VAS score,ODI score,anterior height ratio and Cobb angle before operation and at 5 months after operation were compared between the two groups.Results The operation was successfully completed in both groups.The operation time and hospitalization time of the minimally invasive group were shorter than those of the open group,the amount of intraoperative bleeding was less than that of the open group,and the incision length was less than that of the open group,and the differences were statistically significant(P<0.05).At 5 months after operation,YAS score,ODI score and Cobb angle of injured kyphosis of two groups decreased,height ratio of anterior edge of injured vertebra increased(P<0.05):at 5 months after operation,YAS score and ODI score of the minimally invasive group were lower than those of the open group(P<0.05).Conclusion Percutaneous pedicle screw fixation combined with vertebroplasty has obvious advantages in the treatment of middle-aged and elderly patients with osteoporotic single segment thoracolumbar compression fractures,which can reduce postoperative pain and promote the recovery of injured vertebra function.