改良危亦林悬吊复位法配合经皮钉棒固定微创术治疗胸腰椎骨折疗效观察  

Clinical Study of Minimally Invasive Surgery for Thoracolumbar Fracture based on WEI Yilin'Suspension Reduction Method Combined with Percutaneous Screw Fixation

作　　者：翁嘉琦 李勇[1] 钟发明[1] 周涛斌 叶勇祥 万宣 徐王兵[1] WENG Jia-qi;LI Yong;ZHONG Fa-ming;ZHOU Tao-bin;YE Yong-xiang;WAN Xuan;XU Wang-bing(Department of Spine and Orthopedics,the Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China)

机构地区：[1]江西中医药大学附属医院脊柱骨科,南昌330006

出　　处：《江西中医药大学学报》2022年第1期30-33,共4页Journal of Jiangxi University of Chinese Medicine

基　　金：江西省中医药管理局科技计划项目(2019B023)。

摘　　要：目的:探讨改良后的危亦林悬吊复位法联合经皮钉棒固定微创手术治疗胸腰椎骨折的临床效果。方法:回顾性分析江西中医药大学附属医院脊柱骨科2018年9月—2020年8月收治的50例胸腰椎骨折患者临床资料,观察组(25例)采用改良后的危亦林悬吊复位法联合经皮钉棒固定微创手术治疗,对照组(25例)采用经皮钉棒固定微创手术配合器械撑开复位手术治疗。对比两组患者治疗前、治疗3个月后椎体恢复高度、疼痛程度及腰椎活动功能,并根据VAS评分值,采用尼莫地平法,于治疗3个月后进行临床疗效评定。结果:两组治疗前椎体前缘高度(Ha)、椎体后缘高度(Hp)、视觉模拟评分(VAS)、日本骨科协会(JOA)评分比较,差异无统计学意义(P>0.05)。治疗3个月后,两组Ha、Hp水平均上升,VAS评分均显著下降,JOA评分均上升,且观察组变化较大,差异有统计学意义(P<0.05);观察组总有效率为96%,对照组总有效率为68%,观察组疗效明显优于对照组(χ^(2)=6.64,P<0.05)。结论:(1)两种治疗方法对胸腰椎骨折均有临床疗效;(2)采用改良后的危亦林悬吊复位法联合经皮钉棒固定微创手术治疗胸腰椎骨折效果确切,可有效恢复椎体高度,减轻患者疼痛,促进腰椎功能恢复,值得临床推广。Objective:To investigate the clinical effect of the modified reduction method of WEI Yi-lin's Suspension Reduction Methodcombined with percutaneous nail and stick fixation in the treatment of thoracolumbar fractures.Methods:Retrospective analysis of orthopaedics in September 2018 to August 2020 clinical data of 50 patients with thoracolumbar fractures.The observation group with 25 cases uses the modified WEI Yi-lin combined with percutaneous nail and stick fixation suspended reduction method combined percutaneous screw rod fixation of minimally invasive surgery(25 cases)and the control group using percutaneous screw rod fixation of minimally invasive surgery treatment together with the equipment open reduction method surgery(25 cases).Vertebra recovery height,pain degree and lumbar function were compared between the two groups before treatment and 3 months after treatment.According to VAS scores,nimodiping method was used,with efficacy index n=(pre-treatment score-post-treatment score)/pre-treatment score×100%.Clinical efficacy was evaluated 3 months after treatment.Results:There were no statistically significant differences between the two groups in the height of anterior vertebral body(Ha),height of posterior vertebral body(Hp),visual analogue scale(VAS)and Japanese orthopaedic association(JOA)scores before treatment(P>0.05).After 3 months of treatment,Ha and Hp levels were increased in both groups,VAS scores were significantly decreased,and JOA scores were increased in both groups,and the difference was statistically significant(P<0.05).After 3 months of treatment,the total effective rate of clinical efficacy was 96% in the observation group and 68% in the control group,and the total effective rate of the observation group was significantly better than the control group(χ^(2)=6.64,P<0.05).Conclusion:(1)Both treatments have clinical effects on thoracolumbar fractures.(2)The modified Reduction method of WEI Yilin'S suspension combined with percutaneous nail and rod fixation for minimally invasive surgery has a

关 键 词：胸腰椎骨折 危亦林悬吊复位法 经皮钉棒固定微创术 椎体高度 

分 类 号：R274.13[医药卫生—中医骨伤科学]