摘要
目的 :探讨微创经皮椎弓根螺钉固定技术对胸腰椎骨折患者的临床有效性。方法 :选取2014年5月～2016年12月在我院治疗的胸腰椎骨折患者100例,根据手术方法分为对照组和观察组,对照组47例,观察组53例,对照组患者给予跨伤椎固定术治疗,观察组给予微创经皮椎弓根螺钉固定技术治疗,之后对两组患者临床有效性进行评价。结果 :治疗3月后、末次随访,两组患者伤椎前缘高度均较治疗前显著升高,Cobb角及椎管占位情况均较治疗前显著降低,治疗3月后,观察组患者伤椎前缘高度显著高于对照组,Cobb角及椎管占位情况显著低于对照组,差异显著;末次随访,两组比较伤椎前缘高度、Cobb角及椎管占位情况差异不显著;观察组患者切口长度、手术时间、术中出血量、术后引流量、住院时间及骨折愈合时间分别为:(1.94±0.26)cm、(82.16±3.62)min、(54.24±11.64)mL、(28.82±8.08)mL、(14.03±3.62)d及(4.12±0.10)月,均显著低于对照组,差异有统计学意义;治疗3月后、末次随访,两组患者VAS评分均显著降低,JOA评分均显著升高;观察组患者治疗3月后VAS评分显著低于对照组治疗3月后,JOA评分显著高于对照组治疗后,差异有统计学意义;末次随访,两组患者VAS及JOA评分无显著性差异;治疗后,两组患者A～B级,C～D级所占比例均显著降低,且观察组显著低于对照组,E级所占比例显著上升,且观察组所占比例显著高于对照组。结论 :微创经皮椎弓根螺钉固定技术能有效改善胸腰椎骨折患者手术及伤椎情况,促进患者术后恢复。
Objective To investigate the clinical efficacy of minimally invasive percutaneous pedicle screw fixation in patients with thoracolumbar fractures. Methods A total of 100 patients with thoracolumbar fractures treated in our hospital from May 2014 to December 2016 were selected, According to the surgical methods, the patients were divided into control group and observation group, with 47 cases in control group and 53 cases in observation group. Patients in the control group were treated with traumatic cone fixation. The observation group were given minimally invasive percutaneous pedicle screw fixation, and then the clinical efficacy of the two groups was evaluated. Results After three month of treatment and at the last follow-up, the height of the injured vertebral front of both groups was significantly higher than before treatment, and the Cobb angle and the position of the spinal canal were significantly lower than before treatment. After three month of treatment, the patients in the observation group were injured before the vertebral injury. The margin height was significantly higher than that in the control group. Cobb angle and spinal canal occupancy were significantly lower than those in the control group. At the last follow-up, the vertebral front height, Cobb angle, and spinal canal occupancy were compared between the two groups. The difference was not significant.The length of incision, operation time, blood loss, postoperative drainage, hospital stay and fracture healing time in the observation group were(1.94±0.26) cm,(82.16±3.62) min,(54.24±11.64) ml, 28.82±8.08) mL,(14.03±3.62) d and(4.12±0.10)months, respectively, which were significantly lower than those in the control group. After three month of treatment and the last follow-up, VAS scores of both groups were significantly lower and JOA scores were significantly higher; VAS of patients in the observation group after treatment The score was significantly lower than that of the control group. The JOA score was significantly higher than that of the control group after treatment. At the last follow-up, there was no significant difference in VAS and JOA scores between the two groups. After three month of treatment, the proportions of the A to B and C to D grades in the two groups were significantly lower, and the observation group was significantly lower than the control group, and the E level accounted for The proportion increased significantly, and the proportion of observation group was significantly higher than that of the control group. Conclusion Minimally invasive percutaneous pedicle screw fixation can effectively improve the operation and injury of patients with thoracolumbar fractures, and promote postoperative recovery.
引文
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