摘要
目的比较后路小切口开窗减压融合术联合经皮固定与传统开放椎弓根螺钉固定治疗胸腰椎骨折的临床效果。方法胸腰椎骨折患者102例,按随机数字表法分为观察组和对照组各51例,观察组进行后路小切口开窗减压融合术联合经皮固定术式,对照组进行传统开放椎弓根螺钉固定术式,比较两组手术指标、脊柱改良情况、疼痛视觉模拟(VAS)、Oswestry功能障碍指数(ODI)、日本骨科协会评估疗效(JOA)评分,并记录手术并发症发生情况。结果观察组手术时间长于对照组,切口长度、术中出血量、引流量、住院时间少于对照组,术后VAS、ODI、JOA评分优于对照组(P<0.05);两组术后矢状面Cobb角、椎体前缘高度、矢状位指数、伤椎楔变角均较术前改善(P<0.05),但组间比较差异无统计学意义(P>0.05);两组均未发现并发症情况。结论两种术式均能有效治疗胸腰椎骨折,但后路小切口开窗减压融合术联合经皮固定术式切口小、出血量小、术后疼痛轻、术后恢复快,且不会增加手术风险。
Objective To compare the clinical curative effect between posterior mini incision fenestration decompression and fusion combined with percutaneous fixation and traditional open pedicle screw fixation in the treatment of thoracolumbar fractures.Methods One hundred and two patients with thoracolumbar fractures who were admitted to the hospital were enrolled.They were randomly divided into observation or control group,51 in each group.The observation group was given posterior mini incision fenestration decom pression and fusion combined with percutaneous fixation while the control group was given traditional open pedicle screw fixation.The surgical indexes,spinal improvement,scores of visual analogue scale(VAS),Oswestry dysfunction index(ODI)and Japanese Orthopaedic Association(JOA)were compared between the two groups.The occurrence of surgical complications was recorded.Results The operation time was significantly longer while length of incision,intraoperative blood loss,drainage volume and hospitalization time were less and shorter in the observation group than those of the control group(P<0.05).After surgery,scores of VAS,ODI and JOA in the observation group were better than those in the control group(P<0.05).After surgery,sagittal Cobb angle,anterior vertebral height,sagittal index and wedge angle of injured vertebrae in both groups were significantly improve(P<0.05).There was no significant difference in the above mentioned spinal improvement indexes between the two groups after treatment(P>0.05).There were no com plications in either group.Conclusion Both surgical procedures can effectively treat thoracolumbar fractures.However,the incision of posterior mini incision fenestration decompression and fusion combined with percutaneous fixation is smaller,blood loss is less,postoperative pain is milder and postoperative recovery is quicker without increasing surgery risks.
作者
张云涛
范洪武
曾建勇
蒋丽琴
陶勇
ZHANG Yun tao;FAN Hong wu;ZENG Jian yong;JIANG Li qin;TAO Yong(Department of Orthopaedics Chongqing Fengdu County People's Hospital,Chongqing 408200,China)
出处
《实用医院临床杂志》
2019年第6期205-208,共4页
Practical Journal of Clinical Medicine
关键词
胸腰椎骨折
后路小切口开窗减压融合术
经皮椎弓根螺钉复位内固定
传统开放椎弓根螺钉固定
Thoracolumbar fracture
Posterior mini incision fenestration decompression and fusion
Percutaneous pedicle screw reduction and internal fixation
Traditional open pedicle screw fixation
