单纯后路短节段结合伤椎经皮椎弓根螺钉内固定A1~A3型胸腰椎骨折的近期疗效分析

目的分析单纯后路短节段结合伤椎经皮椎弓根螺钉内固定A1~A3型胸腰椎骨折的近期疗效。方法我院收治的70例行A1~A3型胸腰椎骨折患者,按治疗方式不同分为对照组27例与观察组43例,对照组采用后路短节段结合经皮椎弓根螺钉内固定治疗,观察组采用单纯后路短节段结合伤椎经皮椎弓根螺钉内固定治疗。随访18个月,比较两组围手术期指标、矢状面Cobb角、伤椎前缘高度以及并发症发生情况。结果两组手术时间、术中出血量、切口长度及住院时间比较,差异无统计学意义(P>0.05);与术前比较,两组术后及末次随访矢状面Cobb角明显减小,观察组改善情况优于对照组(P<0.05);两组术后及末次随访伤椎前缘高度明显升高,观察组恢复情况优于对照组(P<0.05);随访18个月,两组均未出现术后感染、椎弓根螺钉退出以及断裂等并发症。结论单纯后路短节段结合伤椎经皮椎弓根螺钉内固定A1~A3型胸腰椎骨折,可明显降低伤椎后凸畸形风险,减少术后椎体丢失,增强患者腰椎功能,近期疗效确切。

Short-term efficacy of simple posterior short-segment combined with percutaneous pedicle screw internal fixation for injured vertebrae of A1~A3 type of thoracolumbar fractures

Objective To analyze the short-term efficacy of simple posterior short-segment combined with percutaneous pedicle screw internal fixation for injured vertebrae of A1~A3 type of thoracolumbar fractures.Methods A retrospective study was performed on 70 patients with A1~A3 type of thoracolumbar fractures in our hospital.They were divided into control group(n=27)and observation group(n=43)according to the treatment methods.The control group was given posterior short-segment combined with percutaneous pedicle screw internal fixation and the observation group was given simple posterior short-segment combined with percutaneous pedicle screw internal fixation for the injured vertebrae.The patients were followed up for 18 months.The perioperative indexes,sagittal Cobb angle,anterior height of injured vertebrae and occurrence of complications were compared between the two groups.Results There were no significant differences in the operative time,intraoperative blood loss,incision length and hospital stay between the two groups(P>0.05).Compared with preoperation,the sagittal Cobb angle was significantly decreased after operation and at the last follow-up in both groups,and the improvement of sagittal Cobb angle in the observation group was better than that in the control(P<0.05).The anterior height of injured vertebrae in the two groups was significantly increased after operation and at the last follow-up,and the recovery of anterior height of the injured vertebrae in the observation group was better than that in the control group(P<0.05).There were no obvious complications such as postoperative infection,pedicle screw withdrawal and rupture in the two groups after 18 months of follow-up.Conclusion For A1~A3 types of thoracolumbar fractures,simple posterior short-segment combined with percutaneous pedicle screw internal fixation for injured vertebrae can significantly reduce the kyphosis risk of injured vertebrae,reduce the postoperative vertebral body loss,and enhance the lumbar function of the patients.The short-term efficacy is significant.