微创经皮椎弓根螺钉内固定治疗无神经损伤胸腰椎骨折疗效分析  

Analysis of the Therapeutic Effect of Minimally Invasive Percutaneous Pedicle Screw Fixation for Thoracolumbar Fracture without Nerve Injury

作　　者：高巨洲 才忠民[1] 王琦[1] 王欢 伍亮 GAO Ju-zhou;CAI Zhong-min;WANG Qi;WANG Huan;WU Liang(Department of Spine Surgery,People's Hospital of Huadu District,Guangzhou,Guangdong Province,510800 China)

机构地区：[1]广州市花都区人民医院脊柱外科,广东广州510800

出　　处：《世界复合医学》2020年第6期83-85,共3页World Journal of Complex Medicine

摘　　要：目的分析在无神经损伤胸腰椎骨折的治疗中实施微创经皮椎弓根螺钉内固定的临床疗效。方法选取该院于2017年4月—2019年5月期间进行治疗的无神经损伤胸腰椎骨折患者60例,按手术方式分为微创组(28例)和开放组(32例)。微创组行经皮椎弓根螺钉内固定手术,开放组行切开椎弓根螺钉内固定手术,对比两组患者手术时间、手术中的出血量、手术后的疼痛视觉模拟评分(VAS评分)、伤椎前缘高度、Cobb角。结果(1)微创组的手术中的出血量(82.3±9.2)mL,手术后1周、1个月的疼痛视觉模拟评分(2.4±0.6)分、(1.05±0.28)分明显低于开放组,两组比较差异有统计学意义(t=28.164、8.449、8.032,P<0.05)。(2)两组术后1周以及12个月的伤椎前缘高度高于手术前,两组手术后1周以及12个月Cobb角低于手术前(P<0.05),两组之间比较差异无统计学意义(P>0.05)。结论对于无神经损伤胸腰椎骨折患者而言,采用微创经皮椎弓根螺钉内固定治疗,治疗效果较为理想,创伤较小,手术后的疼痛也得到了明显的缓解,手术的时间与传统开放手术无明显差异。Objective To analyze the clinical effect of minimally invasive percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures without nerve injury.Methods Sixty patients with thoracolumbar fractures without nerve injury who were treated in the hospital from April 2017 to May 2019 were selected and divided into minimally invasive group(28 cases)and open group(32 cases)according to surgical methods.Percutaneous pedicle screw internal fixation was performed in the minimally invasive group,and open pedicle screw internal fixation was performed in the open group.The operation time,bleeding volume during operation,and visual analog score(VAS score)of pain,height of anterior edge of injured vertebra,Cobb angle after surgery were compared between the two groups.Results 1.The bleeding volume in the minimally invasive group was(82.3±9.2)mL,and the visual analogue scores(2.4±0.6)points and(1.05±0.28)points for pain at 1 week and 1 month after surgery were significantly lower than those in the open group.The difference between the two groups was statistically significant(t=28.164,8.449,8.032,P<0.05).2.The height of the injured vertebral anterior margin at one week and 12 months after operation in both groups was higher than before operation,and the Cobb angle at one week and 12 months after operation in both groups was lower than before operation(P<0.05),there was no statistical difference between the two groups(P>0.05).Conclusion For patients with thoracolumbar fracture without nerve injury,minimally invasive percutaneous pedicle screw internal fixation is adopted to treat the patients with thoracolumbar fracture,the treatment effect is relatively ideal,the trauma is small,the postoperative pain has been significantly relieved,and the operation time is not significantly different from the traditional open surgery.

关 键 词：微创经皮椎弓根螺钉内固定 胸腰椎骨折 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]