MIPPSO对创伤性胸腰椎骨折患者脊柱功能及炎症因子水平的影响

目的探讨MIPPSO对创伤性胸腰椎骨折患者脊柱功能及炎症因子水平的影响。方法选择2013年5月至2018年5月我院收治的71例创伤性胸腰椎骨折患者为研究对象,根据治疗方案的不同将其分为观察组和对照组,对照组34例行传统切开椎弓根螺钉内固定术,观察组37例行MIPPSO,比较2组患者围手术期指标(手术时间、住院时间、术后引流量)、相关评分视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)]、炎症因子肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、白细胞介素1(IL-1)]、影像学指标(伤椎前缘高度比、伤椎后凸Cobb角)及并发症发生率。结果观察组住院时间、术后引流量明显少于对照组,2组比较差异有统计学意义(P<0.05);观察组手术时间明显长于对照组,2组比较差异有统计学意义(P<0.05);2组术前VAS、ODI及血清TNF-α、IL-1、IL-6水平比较差异无统计学意义(P>0.05);2组术后1个月VAS及术后6个月ODI较术前明显下降,差异有统计学意义(P<0.05);观察组术后1个月VAS及术后6个月ODI较对照组下降更明显,2组比较差异有统计学意义(P<0.05);2组术前及术后1个月的伤椎前缘高度比及伤椎后凸Cobb角比较,差异无统计学意义(P>0.05);2组术后1个月伤椎前缘高度比及伤椎后凸Cobb角较术前显著改善,差异有统计学意义(P<0.05);2组术后1个月血清TNF-α、IL-1、IL-6水平较术前明显下降,差异有统计学意义(P<0.05);观察组术后1个月血清TNF-α、IL-1、IL-6水平较对照组明显下降,2组比较差异有统计学意义(P<0.05);2组患者并发症发生率比较差异无统计学意义(P>0.05)。结论MIPPSO对胸腰椎骨折患者有较好疗效,具有创伤小、恢复快、术后疼痛轻、并发症少、胸腰椎矫形效果好、可改善机体功能障碍、降低炎症因子水平等优势。

Effect of MIPPSO on spinal function and inflammatory factor levels in patients with traumatic thoracolumbar spinal fracture

Objective To investigate the effect of minimally invasive percutaneous pedicle screws osteosynthesis(MIPPSO)on the spinal function and the level of inflammatory factors in patients with traumatic thoracolumbar spinal fracture.Methods Totally 71 patients with traumatic thoracolumbar spinal fractures admitted to our hospital from May 2013 to May 2018 were selected and divided into observation group and control group according to different treatment methods.Control group(n=34)received the traditional pedicle screw internal fixation,and observation group(n=37)underwent MIPPSO.Then various indexes were compared between two groups,including perioperative indexes(operation time,length of hospital stay,postoperative drainage volume),related scalesvisual analogue scale(VAS)and Oswestry dysfunction index(ODI)],inflammatory factorstumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1(IL-1)],imaging indicators(anterior height ratio of injured vertebrae,Cobb angle of injured kyphosis)and complication rates.Results The hospitalization time and postoperative drainage volume of the observation group were less than those of the control group,the differences were significant(P<0.05).The operation time of the observation group was more than that of the control group,the difference was significant(P<0.05).There was no significant difference in VAS score,ODI and serum levels of TNF-α,IL-1,IL-6 between the two groups before operation(P>0.05).VAS score at 1 month after surgery and ODI at 6 months after surgery were decreased in both groups,which were lower in the observation group than those in the control group,the differences were significant(P<0.05).There was no difference in anterior height ratio of injured vertebrae and Cobb angle of injured kyphosis before and 1 month after operation(P>0.05).The anterior height ratio of injured vertebrae and Cobb angle of injured kyphosis in both groups at the postoperative 1 month were better than those before operation,the differences were significant(P<0.05).The serum levels of TNF-α,IL-1 and IL-6 at postoperative 1 month were significantly decreased in both groups(P<0.05),which were lower in the observation group than those in the control group,the differences were significant(P<0.05).There was no significant difference in the incidence of complications between two groups(P>0.05).Conclusion MIPPSO has a good curative effect on traumatic thoracolumbar spinal fracture patients,with the advantages of fewer traumas,faster recovery,less pain,fewer complications,and better orthopedic effect of thoracolumbar spine,which can improve the body dysfunction and reduce the inflammatory factors.