经皮椎弓根钉棒置入结合椎体成形治疗胸腰椎压缩性骨折的临床研究  

Therapeutic effects of percutaneous pedicel screw fixation combined with vertebroplasty on thoracolumbar vertebrae compression fractures

作　　者：陈敬忠[1] 张东[1] 肖伟[1] 方凯[1] 黄飞[1] CHEN Jingzhong;ZHANG Dong;XIAO Wei(Department of Orthopedics,The Second People＇ Hospital of Neijiang City,Siehuan,Neijiang 641000,China)

机构地区：[1]四川省内江市第二人民医院骨科,641000

出　　处：《河北医药》2018年第15期2272-2275,共4页Hebei Medical Journal

摘　　要：目的探讨经皮椎弓根钉棒置入结合椎体成形治疗胸腰椎压缩性骨折的临床效果。方法将90例胸腰椎压缩性骨折患者分为后路切开椎弓根镙钉内固定组(A组)、经皮椎弓根钉棒置入术组(B组)及经皮椎弓根钉棒置入联合椎体成形术组(C组),每组30例。分别于术前、术后7 d、术后1个月、术后6个月应用视觉模拟疼痛评分(VAS)对患者疼痛进行评估,采用功能障碍指数评分(ODI)对患者功能障碍进行评价,并记录伤椎增加高度、伤椎中部高度。对比分析3组患者围手术期临床指标及出院时和出院后6个月疗效的优良率。结果 3组患者在出院时和出院后6个月的疗效的优良率差异无统计学意义(P>0.05)。A组患者手术时间、术中出血量及住院时间显著高于B组和C组,差异有统计学意义(P<0.05),而B组与C组间差异无统计学意义(P>0.05)。术中X线照射时间A组<B组<C组,差异均有统计学意义(P<0.05)。治疗后7 d、1个月、6个月伤椎增加高度、伤椎中部高度A组<B组<C组,而VAS评分和ODI评分为A组>B组>C组,差异均有统计学意义(P<0.05)。结论经皮椎弓根钉棒置入结合椎体成形治疗胸腰椎压缩性骨折具有创伤小、出血少、住院时间短等优点,同时能够显著减轻术后疼痛,改善胸腰椎功能。Objective To observe the therapeutic effects of percutaneous pedicel screw fixation combined with vertebroplasty on thoracolumbar vertebrae compression fractures. Methods Ninety patients with thoracolumbar vertebrae compression fractures were randomly divided into open surgery group（group A,n = 30）,percutaneous pedicel screw fixation group（group B,n = 30） and percutaneous pedicel screw fixation combined with vertebroplasty group（group C,n = 30）,with30 patients in each group. The pain of patients before surgery and at 7 d,1 m,6 m after surgery was evaluated by visual analogue pain scale（VAS）,and dysfunction of patients was evaluated by Oswestry disability index score（ODI）. In addition the clinical indexes at peroperative period and excellent and good rate of therapeutic effects were observed and compared among the three groups. Results There were no significant differences in excellent and good rates of therapeutic effects on discharging from hospital and at 6 months after discharging from hospital among the three groups（P〉 0. 05）. The operation time,intraoperative bleeding volume and hospitalization time in group A were significantly higher than those in group B and group C（P〉 0. 05）,however,there were no significant differences between group B and group C（P〈 0. 05）. The intraoperative X-ray exposure time was in order of group A 〈group 〈B group C（P〉 0. 05）. The increased height of injured vertebra,height of central region of injured vertebra at 7 d,1 m,6 m after surgery were in order of group A 〈group B〈 group C,however,the scores of VAS and ODI were in order of group A 〉group B〉 group C（P〈 0. 05）. Conclusion The percutaneous pedicel screw fixation combined with vertebroplasty has the advantages of less trauma,less blood loss,shorter hospital stay,meanwhile,which can significantly relieve postoperative pain and improve thoracolumbar spine function in treatment of thoracolumbar vertebrae compression fractures.

关 键 词：经皮椎弓根钉棒置入 椎体成形术 胸腰椎压缩性骨折 

分 类 号：R683.2[医药卫生—骨科学]