经皮椎弓根置钉内固定治疗成年人AO-A型胸腰椎骨折的临床观察  

Clinical Observation of Percutaneous Pedicle Screw Fixation in the Treatment of Adult AO-A Thoracolumbar Fractures

作　　者：杨忠义[1] 谢胜荣 董迎春[1] 李杰[1] 苟琦 徐盈舒 李旭 YANG Zhong-YI;XIE Sheng-rong;DONG Ying-chun;LI Jie;GOU Qi;XU Ying-shu;LI Xu(Department of Orthopedics,the First People's Hospital of Longquanyi District,Chengdu 610100,Sichuan,China)

机构地区：[1]成都市龙泉驿区第一人民医院骨科,四川成都610100

出　　处：《医学信息》2020年第18期80-82,共3页Journal of Medical Information

基　　金：成都市卫生和计划生育委员会课题(编号:2018023)。

摘　　要：目的探讨经皮椎弓根置钉治疗成年人AO-A型胸腰椎骨折的临床疗效。方法回顾性分析2015年1月~2019年2月我院骨科成年人胸腰椎A型骨折病例82例,根据治疗方法分为保守治疗组(26例)及手术治疗组(56例),手术治疗组行经皮微创置钉手术治疗,比较两组出院时以及手术治疗组入院时、术后1、3个月VAS评分、ODI指数、伤椎后凸Cobb角、伤椎前缘高度及卧床时间。结果手术治疗组出院时VAS评分、ODI指数、后凸Cobb角、伤椎前缘高度分别为(1.68±0.81)分、(37.51±6.81)、(5.79±4.56)°、(86.81±9.32)%,均优于保守治疗组的(3.13±1.06)分、(55.93±7.92)、(18.60±8.96)°、(60.30±15.42)%,差异有统计学意义(P<0.05);手术治疗组入院时、术后1、3个月VAS评分、ODI指数、伤椎后凸Cobb角、伤椎前缘高度比较,差异均有统计学意义(P<0.05)。结论经皮椎弓根置钉内固定是治疗成年人A型胸腰椎骨折的有效方法,与保守治疗相比,经皮椎弓根置钉内固定卧床时间短,伤椎后凸Cobb角、伤椎前缘高度改善效果更好。Objective To investigate the clinical effect of percutaneous pedicle screw placement in the treatment of adult AO-A thoracolumbar fractures.Methods A retrospective analysis of 82 cases of adult thoracolumbar fractures of the orthopedics department in our hospital from January 2015 to February 2019 were divided into conservative treatment group(26 cases)and surgical treatment group(56 cases)according to the treatment method,the surgical treatment group underwent percutaneous minimally invasive nail placement surgery.The two groups were compared when they were discharged from the hospital and when the surgical treatment group was admitted,VAS score,ODI index,Cobb angle of kyphosis,height of the anterior edge of the injured vertebrae,and time in bed at 1 and 3 months after operation.Results The VAS score,ODI index,Cobb angle of kyphosis,and the height of the anterior edge of the injured vertebra at discharge in the surgical treatment group were(1.68±0.81)points,(37.51±6.81),(5.79±4.56)°,(86.81±9.32)%,respectively,all were better than the conservative treatment group's(3.13±1.06)points,(55.93±7.92),(18.60±8.96)°,(60.30±15.42)%,the difference was statistically significant(P<0.05);There were statistically significant differences in the VAS score,ODI index,Cobb angle of the kyphotic spine,and the height of the anterior edge of the spine in the surgical treatment group at admission,1 and 3 months after the operation(P<0.05).Conclusion Percutaneous pedicle screw fixation was an effective method for the treatment of adult type A thoracolumbar fractures.Compared with conservative treatment,percutaneous pedicle screw fixation had shorter bed time,kyphotic Cobb angle and injury.The effect of improving the height of the anterior edge of the vertebra was better.

关 键 词：胸腰椎骨折 经皮椎弓根固定 AO-A型骨折 

分 类 号：R687.3[医药卫生—骨科学]