摘要
目的探讨钉道植骨强化椎弓根螺钉技术在骨质疏松椎体压缩性骨折患者中的应用。方法选取2018年1月至2021年1月骨质疏松椎体压缩性骨折患者96例为研究对象,根据治疗方式分为对照组和观察组,每组48例。对照组患者采用传统椎弓根螺钉技术进行治疗;观察组采用钉道植骨强化椎弓根螺钉技术进行治疗。分别记录两组患者手术时间和术中出血量,临床疗效;采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数评分(ODI)评估患者躯体功能和疼痛的改善情况。术后随访1年,分析伤椎后凸Cobb角、椎体中线高度及椎体前缘高度;并分析两组患者术后并发症。计量数据采用t检验分析。结果对照组患者手术时间和术中出血量[(53.56±4.95)ml和(26.94±2.75)min]明显高于观察组[(33.60±5.46)ml和(20.44±3.28)min],差异有统计学意义(t=18.750、10.510,P<0.05)。对照组患者手术优良率[68.75%(33/49)]明显低于观察组[81.25%(39/48)],差异有统计学意义(χ^(2)=5.012,P<0.05)。对照组术后1个月VAS评分[(3.79±1.14)分]明显高于观察组[(1.94±0.81)分],差异有统计学意义(t=4.068,P<0.05)。对照组术后1个月ODI评分[(31.04±4.28)分]明显高于观察组[(25.98±3.45)分],差异有统计学意义(t=6.384,P<0.05)。对照组术后1个月治疗前伤椎后凸Cobb角[(22.81±4.27)°]明显高于观察组[(16.92±2.29)°],差异有统计学意义(t=8.432,P<0.05)。对照组术后1个月椎体中线高度[(14.43±2.06)mm]明显高于观察组[(19.85±2.74)mm],差异有统计学意义(t=10.930,P<0.05)。对照组术后1个月椎体前缘高度[(14.21±1.80)mm]明显低于观察组[(18.85±2.74)mm],差异有统计学意义(t=9.811,P<0.05)。对照组患者术后并发生发生率[6.25%(3/48)]明显高于观察组[20.83%(10/48)],差异有统计学意义(χ^(2)=5.012,P<0.05)。结论钉道植骨强化椎弓根螺钉技术治疗骨质疏松椎体压缩性骨折疗效显著,术后并发症较少,可降低患者疼痛,改善锥体畸形。
Objective To study the application of pedicle screw technique strengthened by bone grafting in the treatment of osteoporotic vertebral compression fracture.Methods A total of 96 patients with osteoporotic vertebral compression fracture from January 2018 to January 2021 were selected as the study subjects.The patients were divided into control group and observation group according to the treatment method,with 48 cases in each group.The patients in the control group were treated with traditional pedicle screw technique.The observation group was treated with the technique of strengthening pedicle screw with bone grafting through the screw path.The operation time,intraoperative bleeding volume and clinical efficacy of the two groups were recorded.The improvement of patients’physical function and pain was evaluated by visual analogue scale of pain(VAS)and Oswestry dysfunction index score(ODI).The patients were followed up for 1 year after operation.The Cobb angle of kyphosis,the height of centrum midline and the height of anterior edge of vertebra were analyzed.The postoperative complications of the two groups were analyzed.The measurement data were analyzed by t-test.Results The operation time and intraoperative bleeding volume in the control group[(53.56±4.95)ml and(26.94±2.75)min]were significantly higher than those in the observation group[(33.60±5.46)ml and(20.44±3.28)min,t=18.750,10.510,P<0.05].The excellent and good rate of operation in the control group[68.75%(33/49)]was significantly lower than that in the observation group[81.25%(39/48),χ^(2)=5.012,P<0.05].The VAS score in the control group[(3.79±1.14)points]was significantly higher than that in the observation group[(1.94±0.81)points]one month after the operation(t=4.068,P<0.05).The ODI score in the control group[(31.04±4.28)points]was significantly higher than that in the observation group[(25.98±3.45)points]one month after the operation(t=6.384,P<0.05).The Cobb angle of traumatic kyphosis[(22.81±4.27)degrees]in the control group was significantly higher than that in the observation group[(16.92±2.29)degrees]one month after the treatment(t=8.432,P<0.05).The midline height of the vertebral body in the control group[(19.85±2.74)mm]was significantly higher than that in the observation group[(14.43±2.06)mm]one month after the operation(t=10.930,P<0.05).The height of the anterior edge of the vertebral body in the control group[(18.85±2.74)mm]was significantly higher than that in the observation group[(14.21±1.80)mm]one month after the operation(t=9.811,P<0.05).The incidence of postoperative complications in the control group[20.83%(10/48)]was significantly higher than that in the observation group[6.25%(3/48)],(χ^(2)=5.012,P<0.05).Conclusion The treatment of osteoporotic vertebral compression fracture with pedicle screw technique strengthened by bone grafting through the screw path is effective,with less postoperative complications,which can reduce the pain of patients and improve the pyramidal deformity.
作者
方世兵
殷俊
李明恒
陈勤
曾芳俊
陈荣春
Fang Shibing;Yin Jun;Li Mingheng;Chen Qin;Zeng Fangjun;Chen Rongchun(Department of Spine Surgery,Ganzhou People’s Hospital,Ganzhou 341000,China)
出处
《中华实验外科杂志》
CAS
北大核心
2023年第2期365-368,共4页
Chinese Journal of Experimental Surgery
基金
江西省卫生健康委员会科技计划(SKJP220219126)。
关键词
骨质疏松
椎体压缩性骨折
疗效
疼痛
Osteoporosis
Vertebral compression fracture
Efficacy
Pain
