摘要
目的探讨微创经皮椎弓根螺钉内固定术对胸腰椎压缩骨折患者的手术效果。方法选取广州市第一人民医院2018年1月至2020年1月收治的胸腰椎压缩骨折患者60例,采用随机数字法将其分为对照组(30例)和观察组(30例)。对照组男性20例,女性10例,年龄(40.75±15.34)岁;观察组男性19例,女性11例,年龄(40.88±15.56)岁。对照组接受开放椎弓根螺钉内固定术治疗,观察组接受微创经皮椎弓根螺钉内固定术治疗,两组术后均接受1年随访。比较两组患者手术效果(手术时间、术中出血量、术中X线暴露次数、住院时间、术后引流量)以及手术前后影像学指标(椎体前缘高度百分比、后凸Cobb角),并比较两组患者并发症发生率。结果观察组的手术时间、术中出血量、住院时间、术后引流量均明显少于对照组[(82.23±9.34)min比(89.32±10.11)min,(84.34±10.34)ml比(213.22±20.45)ml,(5.12±0.92)d比(8.34±1.35)d,(6.34±0.44)ml比(126.12±9.15)ml],术中X线暴露次数明显多于对照组[(13.98±2.56)比(10.08±1.46)](均P<0.05)。术后1个月,观察组的椎体前缘高度百分比明显小于对照组(P<0.05),术后6个月、12个月,两组椎体前缘高度百分比比较差异均无统计学意义(均P>0.05);术后1个月、6个月、12个月,两组后凸Cobb角比较差异均无统计学意义(均P>0.05)。观察组的术后切口感染、下肢深静脉血栓形成、螺丝松动、背部疼痛等并发症发生率明显低于对照组[43.33%(13/30)比16.67%(5/30)](P<0.05)。结论微创经皮椎弓根螺钉内固定术治疗胸腰椎压缩骨折患者效果显著,创伤小,利于患者恢复,安全性较高,值得在临床推广。
Objective To explore the effect of minimally invasive percutaneous pedicle screw internal fixation in patients with thoracolumbar compression fractures.Methods A total of 60 patients with thoracolumbar compression fractures admitted to Guangzhou First People's Hospital from January 2018 to January 2020 were divided into a control group(n=30)and an observation group(n=30)by the random number table method.In the control group,there were 20 males and 10 females,with an age of(40.75±15.34)years old;there were 19 males and 11 females in the observation group,with an age of(40.88±15.56)years old.The control group received open pedicle screw internal fixation,and the observation group received minimally invasive percutaneous pedicle screw internal fixation.Both groups received a 1-year follow-up postoperatively.The surgical results(operative time,intraoperative blood loss,intraoperative X-ray exposure times,length of hospital stay,postoperative drainage)and imaging indicators(percentage of anterior vertebral height,kyphosis Cobb Angle)before and after the surgery were compared between the two groups,and the incidence of complications was compared between the two groups.Results The operative time,intraoperative blood loss,length of hospital stay,and postoperative drainage volume in the observation group were significantly less than those in the control group[(82.23±9.34)min vs.(89.32±10.11)min,(84.34±10.34)ml vs.(213.22±20.45)ml,(5.12±0.92)d vs.(8.34±1.35)d,(6.34±0.44)ml vs.(126.12±9.15)ml],the times of intraoperative X-ray exposure was significantly higher than that in the control group[(13.98±2.56)vs.(10.08±1.46)](all P<0.05).One month after the surgery,the percentage of anterior vertebral height in the observation group was significantly lower than that in the control group(P<0.05),and there were no statistically significant differences in the percentage of anterior vertebral height between the two groups 6 and 12 months after the surgery(both P>0.05).There were no statistically significant differences in the kyphosis Cobb angle between the two groups 1,6,and 12 months after the surgery(all P>0.05).The incidence of postoperative complications,such as incision infection,lower limb deep vein thrombosis,screw loosening,and back pain,in the observation group was significantly lower than that in the control group[43.33%(13/30)vs.16.67%(5/30)](P<0.05).Conclusion Minimally invasive percutaneous pedicle screw internal fixation has a significant effect in the treatment of thoracolumbar compression fractures,with little trauma,good recovery,and high safety for patients,worthy of clinical promotion.
作者
芦虎
陈伟练
徐巧力
严瀚
Lu Hu;Chen Weilian;Xu Qiaoli;Yan Han(Department of Orthopedics,Guangzhou First People's Hospital,Guangzhou 510000,China)
出处
《国际医药卫生导报》
2021年第20期3213-3216,共4页
International Medicine and Health Guidance News
关键词
微创经皮椎弓根螺钉内固定术
开放椎弓根螺钉内固定术
胸腰椎压缩骨折
手术效果
并发症
Minimally invasive percutaneous pedicle screw internal fixation
Open pedicle screw internal fixation
Thoracolumbar compression fractures
Surgical outcomes
Complications
