开放式椎弓根螺钉内固定术与经皮微创治疗胸腰椎段脊柱骨折疗效分析
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摘要
目的探讨对胸腰椎段脊柱骨折患者分别选择开放式椎弓根螺钉内固定术以及经皮微创椎弓根螺钉内固定术治疗后获得的临床效果。方法选择该院2016年6月—2018年3月收治的62例胸腰椎断脊柱骨折患者作为实验对象;抽签法分组后明确各组手术方式;对照组(31例):选择开放式椎弓根螺钉内固定术展开治疗;观察组(31例):选择经皮微创椎弓根螺钉内固定术展开治疗;观察对比两组胸腰椎段脊柱骨折患者SI(椎体矢状面指数)水平、COBB角(脊柱后凸角度)、椎体前缘高度、手术切口长度、手术平均时间、手术后引流量、手术中失血量、住院时间以及手术后疼痛评分。结果手术前后,两组患者在SI水平、COBB角以及椎体前缘高度方面无明显差异(t=0.173 4,0.286 6,0.018 9,1.187 2,0.177 9,0.539 6,P>0.05);观察组胸腰椎段脊柱骨折患者手术切口长度、手术平均时间、手术后引流量、手术中失血量、住院时间以及手术后疼痛评分均明显少于对照组,差异有统计学意义(t=12.204 4,3.606 6,18.512 6,22.358 3,15.566 7,4.075 0,P<0.05)。结论胸腰椎段脊柱骨折患者在接受治疗期间,同开放式椎弓根螺钉内固定术实施效果比较,经皮微创椎弓根螺钉内固定术的实施,对于患者手术切口长度的减少、手术平均时间缩短、手术后引流量减少、手术中失血量减少、住院时间缩短以及手术后疼痛评分减少,效果明显,最终对于胸腰椎段脊柱骨折患者的早期康复,奠定基础。
Objective To investigate the clinical effects of open pedicle screw fixation and percutaneous minimally invasive pedicle screw fixation in patients with thoracolumbar spine fractures. Methods Sixty-two patients with thoracolumbar fractures of the spine who were admitted to our hospital from June 2016 to March 2018 were selected as experimental subjects. The grouping method was used to determine the surgical methods of each group. The control group(31 cases): the open vertebral arch open screw internal fixation was performed; observation group(31 cases): percutaneous minimally invasive pedicle screw fixation was performed; and SI(vertebral sagittal index) level, COBB angle(spine kyphosis angle), vertebral body height, surgical incision length, average operation time, post-operative drainage, blood loss during surgery, length of hospital stay, and postoperative pain score was compared between the two groups. Results Before and after surgery, there were no significant differences in SI level, COBB angle, and vertebral body height be-tween the two groups(t=0.173 4, 0.286 6, 0.018 9, 1.187 2, 0.177 9, 0.539 6,P<0.05). Observation group thoracolumbar spine spine length of the incision, the average time of surgery, the drainage volume after surgery, the blood loss during surgery, the length of hospital stay, and the postoperative pain score were significantly lower in the fracture patients than in the control group. The difference was statistically significant(t=12.204 4, 3.606 6, 18.512 6, 22.358 3, 15.566 7, 4.075 0,P>0.05). Conclusion Patients with thoracolumbar spine fractures during the treatment were compared with open pedicle screw fixation. Percutaneous minimally invasive pedicle screw fixation was performed to reduce the length of surgical incision and surgery. The average time was shortened, the postoperative drainage volume was reduced, the blood loss during surgery was reduced, the hospitalization time was shortened, and the postoperative pain score was reduced. The effect is obvious, and finally lays a foundation for early rehabilitation of patients with thoracolumbar spine fractures.
Objective To investigate the clinical effects of open pedicle screw fixation and percutaneous minimally invasive pedicle screw fixation in patients with thoracolumbar spine fractures. Methods Sixty-two patients with thoracolumbar fractures of the spine who were admitted to our hospital from June 2016 to March 2018 were selected as experimental subjects. The grouping method was used to determine the surgical methods of each group. The control group(31 cases): the open vertebral arch open screw internal fixation was performed; observation group(31 cases): percutaneous minimally invasive pedicle screw fixation was performed; and SI(vertebral sagittal index) level, COBB angle(spine kyphosis angle), vertebral body height, surgical incision length, average operation time, post-operative drainage, blood loss during surgery, length of hospital stay, and postoperative pain score was compared between the two groups. Results Before and after surgery, there were no significant differences in SI level, COBB angle, and vertebral body height be-tween the two groups(t=0.173 4, 0.286 6, 0.018 9, 1.187 2, 0.177 9, 0.539 6,P<0.05). Observation group thoracolumbar spine spine length of the incision, the average time of surgery, the drainage volume after surgery, the blood loss during surgery, the length of hospital stay, and the postoperative pain score were significantly lower in the fracture patients than in the control group. The difference was statistically significant(t=12.204 4, 3.606 6, 18.512 6, 22.358 3, 15.566 7, 4.075 0,P>0.05). Conclusion Patients with thoracolumbar spine fractures during the treatment were compared with open pedicle screw fixation. Percutaneous minimally invasive pedicle screw fixation was performed to reduce the length of surgical incision and surgery. The average time was shortened, the postoperative drainage volume was reduced, the blood loss during surgery was reduced, the hospitalization time was shortened, and the postoperative pain score was reduced. The effect is obvious, and finally lays a foundation for early rehabilitation of patients with thoracolumbar spine fractures.
引文
[1]陈宇,郑佳状,汪凡栋,等.微创椎弓根螺钉内固定术治疗胸腰段脊柱骨折的效果分析[J].创伤外科杂志,2018,20(9):689-692.
[2]蒋科杰,沈是铭,李戬,等.经皮微创与开放式椎弓根螺钉内固定治疗胸腰段脊柱骨折效果比较[J].中国乡村医药,2018,25(4):25-26.
[3]金中行,徐宏光,刘晨,等.导航下经皮微创附加伤椎内固定治疗胸腰椎骨折的临床疗效分析[J].齐齐哈尔医学院学报,2018,39(3):274-277.
[4]张超,皮红林,刘家矿,等.经皮微创与开放式椎弓根螺钉内固定术对胸腰椎段脊柱骨折的疗效对比[J].医学综述,2015,21(5):899-901.
[5]张志祥.胸腰段脊柱骨折实施经皮微创手术对比开放式椎弓根螺钉内固定术的疗效评析[J].现代诊断与治疗,2017,28(15):2760-2761.
[6]纪军.经皮微创与开放式椎弓根螺钉内固定术治疗胸腰椎段脊柱骨折的疗效对比[J].齐齐哈尔医学院学报,2017,38(6):643-645.
[7]张镇兴.经皮微创椎弓根螺钉内固定手术在胸腰椎脊柱骨折治疗中的临床效果[J].浙江创伤外科,2017,22(1):19-21.
[8]吴然.经皮微创椎弓根螺钉内固定术对胸腰椎段脊柱骨折患者的手术效果及随访观察[J].微创医学,2016,11(4):605-606,615.
[9]胡明云,郑风翠.胸腰椎骨折行经皮微创脊柱椎弓根钉棒系统内固定的疗效分析[J].数理医药学杂志,2015,28(8):1129-1130.
[2]蒋科杰,沈是铭,李戬,等.经皮微创与开放式椎弓根螺钉内固定治疗胸腰段脊柱骨折效果比较[J].中国乡村医药,2018,25(4):25-26.
[3]金中行,徐宏光,刘晨,等.导航下经皮微创附加伤椎内固定治疗胸腰椎骨折的临床疗效分析[J].齐齐哈尔医学院学报,2018,39(3):274-277.
[4]张超,皮红林,刘家矿,等.经皮微创与开放式椎弓根螺钉内固定术对胸腰椎段脊柱骨折的疗效对比[J].医学综述,2015,21(5):899-901.
[5]张志祥.胸腰段脊柱骨折实施经皮微创手术对比开放式椎弓根螺钉内固定术的疗效评析[J].现代诊断与治疗,2017,28(15):2760-2761.
[6]纪军.经皮微创与开放式椎弓根螺钉内固定术治疗胸腰椎段脊柱骨折的疗效对比[J].齐齐哈尔医学院学报,2017,38(6):643-645.
[7]张镇兴.经皮微创椎弓根螺钉内固定手术在胸腰椎脊柱骨折治疗中的临床效果[J].浙江创伤外科,2017,22(1):19-21.
[8]吴然.经皮微创椎弓根螺钉内固定术对胸腰椎段脊柱骨折患者的手术效果及随访观察[J].微创医学,2016,11(4):605-606,615.
[9]胡明云,郑风翠.胸腰椎骨折行经皮微创脊柱椎弓根钉棒系统内固定的疗效分析[J].数理医药学杂志,2015,28(8):1129-1130.
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