应用经皮椎弓根钉内固定术治疗胸腰椎骨折的疗效观察

目的分析应用经皮椎弓根钉内固定术治疗胸腰椎骨折的疗效。方法回顾分析2016年7月至2018年7月在湖北省宜昌市中心人民医院脊柱外科治疗的82例胸腰椎骨折患者的病历资料。将39例接受开放椎弓根螺钉内固定治疗的患者作为开放内固定组,43例接受经皮椎弓根钉内固定治疗的患者作为经皮内固定组。对比2组患者的手术切口长度、手术时间、术中出血量、术后引流量、住院时间、术前及术后伤椎椎体相对高度和Cobb角,同时观察术后当天、术后1周及出院当天患者的疼痛视觉模拟(VAS)评分。结果经皮内固定组手术切口长度、手术时间、术中出血量、术后引流量及住院时间均少于开放内固定组,差异均有统计学意义(均P<0.05)。2组患者术前伤椎椎体相对高度和Cobb角差异无统计学意义(均P>0.05),术后2组上述指标较术前均有改善,差异均有统计学意义(均P<0.05),但组间比较差异无统计学意义(P>0.05)。经皮内固定组术后当天、术后1周及出院当天VAS评分均明显低于开放内固定组,差异均有统计学意义(均P<0.05)。经皮内固定组术后并发症发生率低于开放内固定组(P<0.05)。结论应用经皮椎弓根钉内固定术治疗胸腰椎骨折的疗效显著,可减少患者的痛苦,提高治疗满意度。

Therapeutic effect of percutaneous pedicle fixation screw for thoracolumbar fracture

Objective To analyze the therapeutic effect of percutaneous pedicle screw fixation for thoracolumbar fracture. MethodsA retrospective study of 82 thoracolumbar fracture patients hospitalized between July 2016 and July 2018 was conducted;39 patients were received open pedicle screw internal fixation , and 43 patients were received percutaneous pedicle screw internal fixation. The incision length, operation time, intraoperative blood loss, postoperative drainage volume, hospitalization time, preoperative and postoperative injured vertebral body anterior margin height and Cobb angle were compared between the 2 groups , and the visual analogue score (VAS) of the incision was observed on the day after surgery, one week after surgery, and the day of discharge. ResultsThe incision length, operation time, intraoperative blood loss, postoperative drainage volume and hospitalization time in the percutaneous internal fixation group were less than those in the open internal fixation group, and the differences were statistically significant (all P <0.05). There was no statistically significant difference in preoperative vertebral body height and Cobb angle between the 2 groups (all P >0.05). The above indexes in the 2 groups were significantly improved after surgery compared with those before surgery, with statistically significant difference (all P <0.05), but there was no statistically significant difference between the 2 groups (all P >0.05). The VAS score of the percutaneous internal fixation group were significantly lower than the open internal fixation group on one week after surgery and the day of discharge;the differences were statistically significant (all P <0.05). The total incidence of postoperative complications in the percutaneous internal fixation group was lower than that in the open internal fixation group ( P <0.05). ConclusionThe therapeutic efficacy of percutaneous pedicle screw fixation is significant;it can reduce the pain of patients and improve the satisfaction rate of treatment.