后路微创切口开窗减压结合经皮固定治疗伴神经功能损伤胸腰椎骨折的效果及对创伤应激反应、神经功能的影响  

Effect of posterior minimally invasive incision decompression combined with percutaneous fixation on thoracolumbar fractures with nerve function injury and its influences on traumatic stress response and nerve function

作　　者：李天喜[1] 王闯建[2] LI Tianxi;WANG Chuangjian(Orthopedics Department,the People's Hospital of Huixian,Xinxiang 453600;No.5 Orthopedics Department,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]辉县市人民医院骨科,河南新乡453600 [2]郑州大学第一附属医院骨五科,河南郑州450000

出　　处：《临床医学研究与实践》2023年第3期58-60,共3页Clinical Research and Practice

摘　　要：目的探讨后路微创切口开窗减压结合经皮固定治疗伴神经功能损伤胸腰椎骨折的效果。方法选取2019年1月至2021年1月我院收治的伴神经功能损伤的胸腰椎骨折患者80例,根据手术方式不同将其分为对照组(40例,常规开放减压内固定术)与观察组(40例,后路微创切口开窗减压结合经皮固定)。比较两组的临床疗效。结果术后1 d,观察组的C反应蛋白(CRP)、皮质醇(Cor)、肾上腺素(E)水平均低于对照组(P<0.05);术前及术后1周、6个月,两组的Cobb角、伤椎椎体前缘高度比无明显差异(P>0.05);术前及术后6个月,两组的美国脊柱损伤协会(ASIA)分级无明显差异(P>0.05)。结论后路微创切口开窗减压结合经皮固定治疗伴神经功能损伤的胸腰椎骨折能获得与常规开放减压内固定手术相当的效果,但前者有助于减轻机体应激反应。Objective To investigate the effect of posterior minimally invasive incision decompression combined with percutaneous fixation in the treatment of thoracolumbar fractures with nerve function injury.Methods A total of 80 patients with thoracolumbar fractures with nerve function injury admitted in our hospital from January 2019 to January 2021 were selected and divided into control group(40 cases,conventional open decompression and internal fixation)and observation group(40 cases,posterior minimally invasive incision decompression combined with percutaneous fixation)according to different surgical methods.The clinical efficacy of the two groups were compared.Results At 1 d after operation,the levels of C-reactive protein(CRP),cortisol(Cor)and epinephrine(E)in the observation group were lower than those in the control group(P<0.05).Before operation,1 week and 6 months after operation,there were no significant differences in Cobb angle and anterior vertebral height ratio between the two groups(P>0.05).Before operation and 6 months after operation,there was no significant difference in American Spinal Injury Association(ASIA)grading between the two groups(P>0.05).Conclusion Posterior minimally invasive incision decompression combined with percutaneous fixation in the treatment of thoracolumbar fractures with nerve function injury can obtain the same effect as conventional open decompression and internal fixation,but the former helps to reduce the body’s stress response.

关 键 词：胸腰椎骨折 后路微创切口开窗减压 经皮固定 神经功能损伤 创伤应激反应 

分 类 号：R683.2[医药卫生—骨科学]