摘要
目的研究Wiltse入路椎弓根螺钉固定联合硫酸钙治疗胸腰椎单椎骨折的临床疗效。方法本研究纳入2014年6月-2017年6月本院收治的84例胸腰椎爆裂性骨折患者,随机均分为两组。对照组采用Wiltse入路椎弓根螺钉固定联合经椎弓根自体骨植入治疗;观察组手术入路及内固定与对照组一致,经椎弓根注入硫酸钙,随访超过2年。比较两组手术相关指标、随访期并发症情况以及术前、术后1周、1个月、末次随访时的伤椎Cobb角、VAS评分及伤椎前缘高度比。结果观察组手术时间、手术出血量均显著低于对照组,差异有统计学意义(P<0.05);两组术后1周、1个月、末次随访Cobb角、VAS评分均显著降低,伤椎前缘高度比显著升高,差异有统计学意义(P<0.05),但组间差异无统计学意义(P>0.05);观察组术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论Wiltse入路椎弓根螺钉固定联合经椎弓根植入硫酸钙以及自体骨治疗胸腰椎爆裂性骨折均能有效恢复椎体高度、腰椎稳定性以及改善疼痛症状,近中期疗效无明显差异,但经椎弓根植入硫酸钙能避免自体髂骨取骨造成的额外创伤及并发症。
Objective To study the clinical analysis effect of Wiltse approach pedicle screw fixation combined with calcium sulfate in the treatment of thoracolumbar single vertebrae fractures.Methods Eighty-four patients with thoracolumbar burst fractures admitted to our hospital from June 2014 to June 2017 were selected as the study subjects.They were randomly divided into two groups.The control group was treated with Wiltse approach pedicle screw fixation combined with pedicle autologous bone implantation treatment.The surgical approach and internal fixation of the observation group were consistent with the control group,and calcium sulfate was injected through the pedicle.The patients were followed up for more than 2 years.The surgical related indicators,incidence of complications during follow-up,and the Cobb angle of the injured vertebrae,VAS score and height ratio of the leading edge of the injured vertebrae at preoperation,postoperative 1 week,1 month,last follow-up were compared between the two groups.Results The operation time and the amount of surgical bleeding in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The Cobb angle and VAS scores of the two groups were significantly decreased at 1 week,1 month after operation and at the last follow-up.The height of the injured anterior border was significantly higher than before surgery(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence rate of postoperative complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Wiltse approach pedicle screw fixation combined with vertebral pedicle calcium sulfate and autologous bone in the treatment of thoracolumbar burst fractures can effectively restore vertebral height,lumbar stability and improve pain symptoms,these two methods have no significant difference in the near-term and mid-term curative effect,but the insertion of calcium sulphate through the pedicle can avoid additional trauma and complications caused by autogenous iliac bone extraction.
作者
赵光辉
陈小龙
辛坤
ZHAO Guang-hui;CHEN Xiao-long;XIN Kun(Department of Orthopedics,Traditional Chinese Medicine Hospital of Taihe County,Fuyang,Anhui,236600,China)
出处
《颈腰痛杂志》
2020年第4期448-451,共4页
The Journal of Cervicodynia and Lumbodynia
