摘要
目的 比较不同入路椎弓根螺钉内固定术(PSF)治疗胸腰椎骨折患者的效果。方法 将信阳市中心医院2020年4月至2022年4月收治的105例胸腰椎骨折患者,按照随机数字表法分为3组,均接受PSF治疗,A组接受经皮入路,B组接受Wiltes入路,C组接受后正中入路。采用单因素方差分析、t检验比较3组围手术期指标及术前、术后3个月疼痛程度[视觉模拟评分法(VAS)评分]、Oswestry功能障碍指数(ODI)及伤椎前缘高度、Cobb角。结果 C组患者手术时间最长,其次为A组,B组手术时间最短;A组术中出血量最少,住院时间最短,其次为B组,C组术中出血量最多,住院时间最长(P<0.05)。术后3个月,3组患者VAS评分、改良ODI均降低,且A组VAS评分最低,其次为B组,C组最高(P<0.05);3组患者术后3个月ODI、伤椎前缘高度、Cobb角比较差异无统计学意义(P>0.05)。结论 经皮入路PSF治疗胸腰椎骨折损伤更轻、术后恢复更快、术后疼痛程度最轻,经Wiltes入路操作手术时间最短,3种入路对胸腰椎骨折患者手术治疗效果相当。
Objective To compare the effects of different approaches for pedicle screw internal fixation(PSF)in patients with thoracolumbar fractures.Methods A total of 105 patients with thoracolumbar fracture admitted to Xinyang Central Hospital from April 2020 to April 2022 were randomly divided into three groups according to the random number table method.All patients received PSF treatment.Group A received percutaneous approach,group B received Wiltes approach,and group C received posterior median approach.One way analysis of variance and t-test were used to compare the perioperative indexes,preoperative and postoperative pain levels[visual analogue scale(VAS)score],Oswestry disability index(ODI)and anterior height of injured vertebra,Cobb angle of the three groups.Results The operation time was the longest in group C,followed by group A,and the shortest in group B.Group A had the least intraoperative bleeding and the shortest hospital stay,followed by group B,group C had the most intraoperative bleeding and the longest hospital stay(P<0.05).Three months after operation,the VAS score and modified ODI of the three groups decreased,and the VAS score of group A was the lowest,followed by group B and group C was the highest(P<0.05).There was no statistically differences in ODI,height of anterior edge of injured vertebra and Cobb angle among the three groups 3 months after operation(P>0.05).Conclusion Percutaneous pedicle screw fixation for thoracolumbar fractures has less injury,faster postoperative recovery,the lightest degree of postoperative pain,and the shortest operation time through Wiltes approach.The three approaches have the same effect on patients with thoracolumbar fractures.
作者
潘林
PAN Lin(Department of Orthopedics,Xinyang Central Hospital,Xinyang 464000,China)
出处
《河南医学研究》
CAS
2023年第8期1468-1471,共4页
Henan Medical Research
关键词
胸腰椎骨折
椎弓根螺钉内固定术
经皮入路
Wiltes入路
后正中入路
thoracolumbar fracture
pedicle screw internal fixation
percutaneous approach
wiltes approach
posterior median approach
