后路椎弓根内固定术联合椎体成形术治疗老年胸腰段脊柱骨折疗效分析  

Clinical Efficacy Analysis of Posterior Pedicle Screw Internal Fixation Combined with Vertebroplasty in the Treatment of Thoracolumbar Spinal Fracture in the Elderly

作　　者：付建仲 冯慧峰 FU Jianzhong;FENG Huifeng(Department of Orthopedics,Zhumadian Duanzhuang Sunquangui Orthopedic Hospital,Zhumadian,Henan 463000,China)

机构地区：[1]驻马店段庄孙全贵骨科医院骨科,河南驻马店463000

出　　处：《中国烧伤创疡杂志》2022年第6期418-421,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探讨后路椎弓根内固定术联合椎体成形术治疗老年胸腰段脊柱骨折的临床疗效。方法选取2017年2月至2020年2月驻马店段庄孙全贵骨科医院收治的126例老年胸腰段脊柱骨折患者作为研究对象,并按照不同治疗方法将其分为研究组(63例)与对照组(63例),研究组患者采用后路椎弓根内固定术联合椎体成形术治疗,对照组患者单纯采用后路椎弓根内固定术治疗,对比观察两组患者Cobb角、椎管狭窄率(SSR)、椎体高度压缩率、内固定松动率及骨性愈合率。结果术后7 d及术后6个月,研究组患者Cobb角、SSR、椎体前缘压缩率及椎体后缘压缩率均明显小于对照组(术后7 d:t=17.860、7.559、6.251、8.402,P均<0.001;术后6个月:t=16.460、9.641、8.122、9.107,P均<0.001);术后6个月,研究组患者内固定松动率为4.8%,与对照组患者的内固定松动率14.3%无明显差异(χ^(2)=3.316,P=0.069);术后6个月,研究组患者骨性愈合率为95.2%,显著高于对照组患者的骨性愈合率58.7%(χ^(2)=23.695,P<0.001)。结论后路椎弓根内固定术联合椎体成形术治疗老年胸腰段脊柱骨折,有利于椎体高度重建,减少椎管狭窄的发生,促进骨性愈合,治疗效果较好,值得临床推广应用。Objective To investigate the clinical efficacy of posterior pedicle screw internal fixation combined with vertebroplasty in the treatment of thoracolumbar spinal fracture in the elderly.Methods 126 patients with thoracolumbar spinal fracture,admitted to Zhumadian Duanzhuang Sunquangui Orthopedic Hospital from February 2017 to February 2020,were enrolled as research subjects and divided,based on the treatments they received,into study group(n=63)and control group(n=63).Patients in study group were treated with posterior pedicle screw internal fixation combined with vertebroplasty,whereas patients in control group were treated with posterior pedicle screw internal fixation alone.The Cobb angle,spinal stenosis rate(SSR),vertebral compression rate,internal fixation loosening rate and bone union rate were observed and compared between the two groups.Results Respectively at 7 days and 6 months after operation,the Cobb angle,SSR,vertebral anterior edge compression rate and vertebral posterior edge compression rate were all significantly lower in study group compared with control group(7 d after operation:t=17.860,7.559,6.251 and 8.402,all P<0.001;6 months after operation:t=16.460,9.641,8.122 and 9.107,all P<0.001);6 months after operation,the internal fixation loosening rate was 4.8%in study group,which showed no significant difference compared with 14.3%in control group(χ^(2)=3.316,P=0.069),and the bone union rate of patients in study group was 95.2%,being significantly higher than 58.7%in control group(χ^(2)=23.695,P<0.001).Conclusion Posterior pedicle screw internal fixation combined with vertebroplasty in the treatment of thoracolumbar spinal fractures in the elderly can facilitate the reconstruction of vertebral height,reduce the occurrence of spinal stenosis,and promote bony union.The curative effect is definite,deserving to be promoted in clinical practice.

关 键 词：脊柱骨折 胸腰椎 老年 后路椎弓根内固定术 椎体成形术 骨性愈合 

分 类 号：R687.3[医药卫生—骨科学]