经皮与WILTSE入路椎弓根螺钉治疗无神经症状型胸腰椎骨折的疗效对比  

Comparison of the curative effect of percutaneous and WILTSE approach for the treatment of thoracolumbar fractures without nerve injury with pedicle screws

作　　者：林森[1] 周涛[1] 李健[1] LIN Sen;ZHOU Tao;LI Jian(Department of Spine Surgery,Maanshan People's Hospital,Maanshan Anhui 243000,China)

机构地区：[1]马鞍山市人民医院脊柱骨科,安徽马鞍山243000

出　　处：《临床和实验医学杂志》2022年第7期735-739,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省科技重大专项项目(编号:17030901037)。

摘　　要：目的对比分析使用经皮椎弓根螺钉与椎旁肌间隙入路(WILTSE入路)椎弓根螺钉治疗单节段无神经损伤型胸腰段椎体骨折的临床疗效。方法前瞻性选取2018年6月至2019年12月期间于马鞍山市人民医院行椎弓根螺钉治疗的60例无神经损伤型单节段胸腰段椎体骨折病例为研究对象,采用简单随机法分为对照组与实验组,各30例。对照组采用WILTSE入路行椎弓根螺钉内固定术,实验组采用经皮椎弓根螺钉内固定术。记录两组样本病例相关数据[前缘高度比、Oswestry功能障碍指数问卷表(ODI)、视觉模拟量表(VAS)评分等],比较两组患者各项围术期手术治疗、手术前后的VAS、ODI评分及影像学测量结果。结果实验组患者的手术切口长度、手术用时、术中出血量、住院时间均低于对照组,差异均有统计学意义(P<0.05)。术后1周和术后1年,两组的VAS和ODI评分较术前均降低,术后1年低于术后1周,差异均有统计学意义(P<0.05)。术后1周和术后1年,实验组的VAS和ODI评分均低于对照组,差异均有统计学意义(P<0.05)。术后1周和术后1年,两组的伤椎椎体前缘高度比均升高,伤椎Cobb's角均降低,差异均有统计学意义(P<0.05)。结论经皮椎弓根螺钉技术治疗无神经损伤型单节段胸腰段椎体骨折与WILTSE入路手术相比,手术过程短,出血量低,创伤小,术后痛感轻,为治疗提供了更多选择。Objective To compare and analyze the clinical efficacy of percutaneous pedicle screw and Wiltse approach in the treatment of single level thoracolumbar vertebral fracture without nerve injury.Methods From June 2018 to December 2019,60 cases of single-segment thoracolumbar vertebral fractures without nerve injury who underwent pedicle screw treatment in Maanshan People's Hospital from June 2018 to December 2019 were prospectively selected as the research objects,and divided into control group and experimental group by simple random method,30 cases in each group.The control group was treated with the WILTSE approach for pedicle screw internal fixation,and the experimental group was treated with percutaneous pedicle screw internal fixation.The sample case-related data[(leading edge height ratio,Oswestry disability index(ODI)score,visual analog scale(VAS)score,etc.)]of the two groups were recorded,the perioperative surgical treatment,VAS,ODI scores and imaging measurement results before and after surgery were compared between the two groups.Results The length of surgical incision,operation time,intraoperative blood loss,and length of stay in the experimental group were lower than those in the control group,and the difference was statistically significant(P<0.05).The VAS and ODI scores of the two groups were lower than that of the preoperative 1 week and 1 year after the operation,and the difference was statistically significant(P<0.05).The VAS and ODI scores of the experimental group were lower than those of the control group 1 week after operation and 1 year after operation,and the difference was statistically significant(P<0.05).The ratio of the anterior edge height of the injured vertebral body in the two groups increased at 1 week and 1 year after the operation,and the Cobb's angle of the injured vertebra was decreased,the difference was statistically significant(P<0.05).Conclusion Compared with Wiltse approach,percutaneous pedicle screw technique for the treatment of single level thoracolumbar vertebral fracture

关 键 词：无神经症状型胸腰椎骨折 经皮椎弓根螺钉 WILTSE入路 

分 类 号：R687.3[医药卫生—骨科学]