胸腰椎骨折行经皮椎弓根螺钉内固定治疗的效果观察及评估  

Efficacy observation and evaluation on percutaneous pedicle screw internal fixation for thoracolumbar fractures

作　　者：王忻[1] 赵毅[1] 祁学强 常建琪[1] 

机构地区：[1]延安市人民医院骨科一病区,陕西延安716000

出　　处：《武警后勤学院学报（医学版）》2016年第7期540-542,547,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】研究并探讨胸腰椎骨折行经皮椎弓根螺钉内固定治疗的效果。【方法】选取2012年1月至2015年3月在我院进行手术治疗且完成随访的68例胸腰椎骨折患者作为此次回顾性研究的对象,根据手术方式将患者分为两组,对照组实施传统开放椎弓根螺钉内固定术,观察组实施经皮椎弓根螺钉内固定术。比较两组患者的手术时间、术中出血量、住院时间,并对两组患者手术前后的伤椎前后缘高度比、后凸角度、视觉模拟评分法(visual analog scale,VAS)评分进行比较。【结果】两组患者的手术时间比较无明显差异(P>0.05),但观察组的术中出血量、住院时间均较对照组明显更低(P<0.05)。与手术前相比,手术后两组患者的伤椎前缘高度比、伤椎后缘高度比均明显增高(P<0.05),两组患者的后凸角度均明显减小(P<0.05),但在手术后,两组患者的各项指标在组间进行比较,差异无统计学意义(P>0.05)。与手术前相比,手术后两组患者的VAS评分均明显降低(P<0.05),但手术后观察组的VAS评分较对照组明显更低(P<0.05)。【结论】采取经皮椎弓根螺钉内固定术治疗能够有效改善胸腰椎骨折患者的椎体高度,减轻脊柱后凸畸形,还能有效促进术后恢复。[Objective]To explore the effect of percutaneous pedicle screw internal fixation for thoracolumbar fractures. [Methods] A total of 68 patients with thoracolumbar fractures undergoing surgical treatment and follow-up in our hospital were retrospectively investigated from January 2012 to March 2015. According to operation modes; the patients were divided into two groups： control group and observation group. Patients in control group were treated with traditional open pedicle screw internal fixation, and those in observation group were treated with percutaneous pedicle screw internal fixation. Operation time, blood loss and hospitalization time were compared between the two groups. The height ratio of anterior and posterior margins in the injured vertebrae, kyphosis angle and visual analog scale （VAS） in both groups were compared before and after the operation. [ Results ] There was no significant difference in operation time between the two groups （P〉0.05）. However, blood loss and hospitalization time in observation group were significantly less than those in control group （P〈0.05）. Compared with those before the surgery, the height ratios of anterior and posterior margins in the injured vertebrae both increased significantly after the surgery in the two groups （P〈0.05）; kyphosis angle of both groups decreased significantly （P〈0.05）. After the surgery, the indexes between the two groups showed no significant difference （P〉0.05）. Compared with those before the operation, the scores of VAS in both groups were significantly lower after the operation （P〈0：05）. However, the score of VAS in observation group was significantly lower than that in control group （P〈0.05）. [Conclusion] The percutaneous pedicle screw internal fixation can effectively improve the vertebral height in patients with thoracolumbar fractures, reduce kyphotic deformity bending and promote the postoperative recovery.

关 键 词：胸腰椎骨折 经皮椎弓根螺钉内固定术 传统开放椎弓根螺钉内固定术 

分 类 号：R687.3[医药卫生—骨科学]