后路短节段椎弓根螺钉内固定治疗腰椎骨折的疗效观察

目的探讨后路短节段椎弓根螺钉内固定治疗腰椎骨折的临床疗效。方法将86例腰椎骨折患者按随机数字表法分为观察组和对照组各43例,观察组采用后路短节段椎弓根螺钉内固定,对照组行传统手术方法固定,比较两组手术情况、Oswestry功能障碍评分(ODI)、疼痛评分(VAS)及不良反应。结果观察组出血量、手术时间、切口长度均小于对照组,差异有统计学意义(P0.05);ODI评分和VAS评分的时间点间及分组和时间的交互作用显著(P0.05),ODI评分组间差异显著(P0.05),但VAS评分不显著(P0.05);两组ODI评分和VAS评分均随时间的推移而趋于下降(P0.05),ODI评分术后3月、6月差异显著(P0.05),VAS评分术后3月差异显著(P0.05),其他时间点两指标均不显著(P0.05);观察组术后Frankel分级显著优于对照组,差异有统计学意义(P0.05)。结论腰椎骨折患者行后路短节段椎弓根螺钉内固定具有疗效好、临床症状缓解快、神经功能影响轻的特点,有重要参考价值。

Effect Study on Posterior Short Segment Pedicle Screw Internal Fixation in the Treatment of Lumbar Vertebra Fracture

Objective To study the clinical effect of posterior short segment pedicle screw internal fixation in the treatment of lumbar vertebra fracture. Methods 86 patients with lumbar vertebra fracture were randomly divided into two groups,43 cases in each group. 43 cases of observation group were treated with posterior short segment pedicle screw internal fixation,while 43 cases of control group were treated with traditional fixation method. The operation status,ODI score,VAS score and adverse reaction were compared.Results The bleeding volume,operation time,incision length of observation group were significant lower than those of control group（ P 〈 0. 05）; the ODI and VAS scores in different timings were different and there was the interaction between group and time（ P 〈 0. 05）. There was significant difference of ODI scores between two groups（ P 〈 0. 05）,while no difference of VAS scores between two groups was shown（ P 〉 0. 05）. The ODI and VAS score of two groups tended to decline along with time（ P 〈 0. 05）. The ODI scores of two groups had significant differences 3 months and 6 months after the operation（ P 〈 0. 05）,and VAS scores of two groups had significant difference 3 months after the operation（ P 〈 0. 05）. Frankel grade of observation group was significant better than control group（ P 〈 0. 05）. Conclusion Compared with traditional fixation,posterior short segment pedicle screw internal fixation in the treatment of lumbar vertebra fracture has the advantages of better effect,faster relief of clinical symptoms and less influence on neurological function.