Sextant微创经皮椎弓根螺钉内固定手术治疗中老年脊柱骨折患者的疗效及对患者生存质量的影响
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摘要
目的研究分析Sextant微创经皮椎弓根螺钉内固定手术治疗中老年脊柱骨折的疗效及对患者生存质量的影响,为临床治疗提供参考。方法选取2012年3月至2017年3月期间在本院接受诊治的86例中老年胸腰椎段脊柱骨折患者作为研究对象,根据随机数表法分为对照组41例、研究组45例。对照组患者实施开放式椎弓根螺钉内固定术治疗,研究组患者接受Sextant微创经皮椎弓根螺钉内固定术治疗。比较两组手术指标、影像学指标及生存质量情况。结果两组患者的手术时间差异无统计学意义;研究组患者术中出血量、术后住院时间均低于对照组,差异有统计学意义(P<0.05);两组患者术后椎体矢状面指数、椎体前缘高度均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后两组患者的Cobb′s角均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后研究组患者生理职能、情感职能、躯体疼痛、社会功能、总体健康评分均高于对照组,差异有统计学意义(P<0.05)。结论 Sextant微创经皮椎弓根螺钉内固定手术治疗中老年脊柱骨折效果显著,能有效减轻机体损伤,改善患者的脊柱后凸角度及椎体高度,促进患者身体恢复,提高患者生存质量,值得临床推广。
Objective To study the effect of Sextant minimally invasive percutaneous pedicle screw internal fixation in the treatment of middleaged and elderly patients with spinal fractures and quality of life of patients, provide a reference for clinical treatment. Methods 86 cases of elderly patients with thoracolumbar spine fractures treated in our hospital from March 2012 to March 2017 were selected as the subjects of this study. According to random number table, all patients were divided into control group(n=41) and study group(n=45). The patients in the control group were treated with open pedicle screw internal fixation, and the patients in the study group were treated with Sextant minimally invasive percutaneous pedicle screw internal fixation. The operation indexes, imaging indexes and quality of life of the two groups were compared between the two groups.Results There was no significant difference in operative time between the two groups. The bleeding volume and postoperative hospital stay in study group were lower than those in control group, with significant difference(P<0.05). The sagittal index of vertebral body and the height of the anterior vertebral body in the two groups were significantly higher than those in the control group, and the difference was statistically significant(P<0.05).The postoperative Cobb' s angle of the two groups were lower than preoperative, and the study group was lower than the control group, the difference was statistically significant(P<0.05); The postoperative study group had higher physical function, emotional function, somatic pain, social function and overall health score than the control group(P<0.05). Conclusion Sextant minimally invasive percutaneous pedicle screw fixation for the treatment of middle-aged and elderly spine fracture effect is significant, can effectively reduce the body injury, improve the patient's kyphosis angle and vertebral height, promote patient recovery and improve patient quality of life, it is worth clinical Promotion.
Objective To study the effect of Sextant minimally invasive percutaneous pedicle screw internal fixation in the treatment of middleaged and elderly patients with spinal fractures and quality of life of patients, provide a reference for clinical treatment. Methods 86 cases of elderly patients with thoracolumbar spine fractures treated in our hospital from March 2012 to March 2017 were selected as the subjects of this study. According to random number table, all patients were divided into control group(n=41) and study group(n=45). The patients in the control group were treated with open pedicle screw internal fixation, and the patients in the study group were treated with Sextant minimally invasive percutaneous pedicle screw internal fixation. The operation indexes, imaging indexes and quality of life of the two groups were compared between the two groups.Results There was no significant difference in operative time between the two groups. The bleeding volume and postoperative hospital stay in study group were lower than those in control group, with significant difference(P<0.05). The sagittal index of vertebral body and the height of the anterior vertebral body in the two groups were significantly higher than those in the control group, and the difference was statistically significant(P<0.05).The postoperative Cobb' s angle of the two groups were lower than preoperative, and the study group was lower than the control group, the difference was statistically significant(P<0.05); The postoperative study group had higher physical function, emotional function, somatic pain, social function and overall health score than the control group(P<0.05). Conclusion Sextant minimally invasive percutaneous pedicle screw fixation for the treatment of middle-aged and elderly spine fracture effect is significant, can effectively reduce the body injury, improve the patient's kyphosis angle and vertebral height, promote patient recovery and improve patient quality of life, it is worth clinical Promotion.
引文
[1]李志,沈晓钟,马建武,等.微创经皮椎弓根螺钉Sextant内固定治疗老年骨质疏松性脊柱骨折的疗效[J].中国老年学杂志,2017,37(8):1977-1979.
[2]钱志渊.脊柱胸腰段骨折经皮后路微创椎弓根螺钉固定的疗效分析[J].浙江临床医学,2016,18(7):1310-1311.
[3] Zhang L, Wang J, Feng X, et al. A comparison ofhigh viscosity bone cement and low viscosity bonecement vertebroplasty for severe osteoporotic vertebral compression fractures[J]. Clinical neurologyand neurosurgery, 2015,129(24):10-16.
[4]王清泽,王相利,张金锋,等.椎体成形术与非手术治疗骨质疏松性椎体压缩性骨折安全性的Meta分析[J].脊柱外科杂志,2016,14(5):306-311.
[5]胥少汀,葛宝丰,徐印钦.实用骨科学[M].4版.北京:人民军医出版社,2012:2100.
[6]王兵站,谭洪宇,刘屹林,等.经皮椎体成形术与经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效比较[J].中国老年学杂志,2015,35(24):7121-7123.
[7]曾钊,周春芳.经皮椎体成形术对脊柱转移瘤患者临床效果观察及安全性评价[J].湖南师范大学学报,2015,12(3):73-75.
[8]刘伯昊,黎泽森,李美军,等.经皮椎体成形术与椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床分析[J].临床和实验医学杂志,2013,12(5):357-358,361.
[9] Wang C, Fan S, Liu J, et al. Basivertebral foramencould be connected with intrave Rtebral cleft:a potential risk factor of cement leakage in percutaneous kyphoplasty[J]. Spine J, 2014,14(8):1551-1558.
[10]徐超,李国华,亚力坤,等.高粘度与低粘度骨水泥PVP治疗骨质疏松椎体压缩骨折的疗效和并发症[J].中国脊柱脊髓杂志,2014,24(10):900-905.
[11]徐建成,白靖平,锡林宝勒日,等.注入骨水泥椎体成形与非手术治疗骨质疏松性椎体压缩骨折的Meta分析[J].中国组织工程研究与临床康复,2011,15(13):2366-2370.
[12]杨剑锋,孙春汉.经皮椎体成形术与椎体后凸成形术治疗骨质疏松性椎体骨折的疗效比较[J].现代诊断与治疗,2014,25(19):4359-4361.
[13]娄玉健,王秀会,陆耀刚,等.骨质疏松性椎体压缩骨折椎体后凸成形术与非手术治疗的临床对照研究[J].中国骨与关节损伤杂志,2014,29(1):15-17.
[14]王涛,马信龙,张晓林.椎体成形术治疗胸腰椎骨质疏松性压缩骨折的研究进展[J].中华创伤杂志,2016,32(7):661-665.
[15] Zhang L, Wang J, Feng X, et al. A comparison ofhigh viscosity bone cement and low viscosity bonecement vertebroplasty for severe osteoporotic vertebral compression fractures[J]. Clinical neurologyand neurosurgery, 2015,129(24):10-16.
[16]洪全明,杨可佳,沈飞,等.前、后路内固定融合术治疗脊柱胸腰段骨折的比较研究[J].创伤外科杂志,2016,18(12):708-712.
[17]孔祥瑞,刘德政,刘海峰,等.骨质疏松腰椎退行性疾病的手术治疗分析[J].湖南师范大学学报,2015,12(4):121-123.
[18]陈彦,初同伟,杨波,等.经伤椎置钉短节段固定治疗胸腰段脊柱骨折的疗效分析[J].重庆医学,2016,45(13):1841-1843.
[19]朱鑫,徐海斌.后路经伤椎固定联合伤椎及后外侧植骨治疗胸腰椎爆裂性骨折脊髓神经功能恢复研究[J].中国实用神经疾病杂志,2015,18(5):6-8.
[2]钱志渊.脊柱胸腰段骨折经皮后路微创椎弓根螺钉固定的疗效分析[J].浙江临床医学,2016,18(7):1310-1311.
[3] Zhang L, Wang J, Feng X, et al. A comparison ofhigh viscosity bone cement and low viscosity bonecement vertebroplasty for severe osteoporotic vertebral compression fractures[J]. Clinical neurologyand neurosurgery, 2015,129(24):10-16.
[4]王清泽,王相利,张金锋,等.椎体成形术与非手术治疗骨质疏松性椎体压缩性骨折安全性的Meta分析[J].脊柱外科杂志,2016,14(5):306-311.
[5]胥少汀,葛宝丰,徐印钦.实用骨科学[M].4版.北京:人民军医出版社,2012:2100.
[6]王兵站,谭洪宇,刘屹林,等.经皮椎体成形术与经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效比较[J].中国老年学杂志,2015,35(24):7121-7123.
[7]曾钊,周春芳.经皮椎体成形术对脊柱转移瘤患者临床效果观察及安全性评价[J].湖南师范大学学报,2015,12(3):73-75.
[8]刘伯昊,黎泽森,李美军,等.经皮椎体成形术与椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床分析[J].临床和实验医学杂志,2013,12(5):357-358,361.
[9] Wang C, Fan S, Liu J, et al. Basivertebral foramencould be connected with intrave Rtebral cleft:a potential risk factor of cement leakage in percutaneous kyphoplasty[J]. Spine J, 2014,14(8):1551-1558.
[10]徐超,李国华,亚力坤,等.高粘度与低粘度骨水泥PVP治疗骨质疏松椎体压缩骨折的疗效和并发症[J].中国脊柱脊髓杂志,2014,24(10):900-905.
[11]徐建成,白靖平,锡林宝勒日,等.注入骨水泥椎体成形与非手术治疗骨质疏松性椎体压缩骨折的Meta分析[J].中国组织工程研究与临床康复,2011,15(13):2366-2370.
[12]杨剑锋,孙春汉.经皮椎体成形术与椎体后凸成形术治疗骨质疏松性椎体骨折的疗效比较[J].现代诊断与治疗,2014,25(19):4359-4361.
[13]娄玉健,王秀会,陆耀刚,等.骨质疏松性椎体压缩骨折椎体后凸成形术与非手术治疗的临床对照研究[J].中国骨与关节损伤杂志,2014,29(1):15-17.
[14]王涛,马信龙,张晓林.椎体成形术治疗胸腰椎骨质疏松性压缩骨折的研究进展[J].中华创伤杂志,2016,32(7):661-665.
[15] Zhang L, Wang J, Feng X, et al. A comparison ofhigh viscosity bone cement and low viscosity bonecement vertebroplasty for severe osteoporotic vertebral compression fractures[J]. Clinical neurologyand neurosurgery, 2015,129(24):10-16.
[16]洪全明,杨可佳,沈飞,等.前、后路内固定融合术治疗脊柱胸腰段骨折的比较研究[J].创伤外科杂志,2016,18(12):708-712.
[17]孔祥瑞,刘德政,刘海峰,等.骨质疏松腰椎退行性疾病的手术治疗分析[J].湖南师范大学学报,2015,12(4):121-123.
[18]陈彦,初同伟,杨波,等.经伤椎置钉短节段固定治疗胸腰段脊柱骨折的疗效分析[J].重庆医学,2016,45(13):1841-1843.
[19]朱鑫,徐海斌.后路经伤椎固定联合伤椎及后外侧植骨治疗胸腰椎爆裂性骨折脊髓神经功能恢复研究[J].中国实用神经疾病杂志,2015,18(5):6-8.