比较经皮与开放椎弓钉固定治疗无神经损伤胸椎骨折的临床效果  

To compare the clinical Effect of percutaneous and open pedicle Screw Fixation in the Treatment of thoracic vertebral Fracture without Nerve Injury

作　　者：徐林飞 沈皆亮[2] XU Linfei;SHEN Jieliang(Department of Orthopedics,Henan Provincial Thoracic Hospital,Henan 471000,China;Department of Orthopedics,The First Affiliated Hospital of Chongqing Medical University,Henan 471000,China)

机构地区：[1]河南省胸科医院骨科,河南郑州450000 [2]重庆医科大学附属第一医院骨科,重庆400016

出　　处：《临床研究》2023年第3期15-18,共4页Clinical Research

基　　金：胸腔镜下前路微创治疗胸椎结核的临床研究(LHGJ20210228)。

摘　　要：目的比较经皮与开放椎弓钉固定治疗无神经损伤胸椎骨折的临床效果。方法选取2021年3月至2022年9月河南省胸科医院收治的86例无神经损伤胸椎骨折患者,按照随机数字表法分成研究组(N=43)与对照组(N=43),对照组给予开放椎弓钉固定治疗,研究组给予经皮椎弓钉固定治疗,对两组围手术期指标、疼痛程度[视觉模拟评分法(VAS)评分]、后凸Cobb角、伤椎前缘高度及并发症进行比较。结果与对照组比较,研究组手术及住院时间、切口长度均更短,差异有统计学意义(P<0.05),术中出血量更少,差异有统计学意义(P<0.05)。术后两组VAS评分均降低,差异有统计学意义(P<0.05),研究组VAS评分较对照组更低,差异有统计学意义(P<0.05)。术后两组后凸Cobb角均降低,差异有统计学意义(P<0.05),伤椎前缘高度均提高,差异有统计学意义(P<0.05),但研究组后凸Cobb角、伤椎前缘高度与对照组比较差异无统计学意义(P>0.05)。研究组并发症发生率(6.98%)低于对照组(23.26%),差异有统计学意义(P<0.05)。结论与开放椎弓钉固定相比,经皮椎弓钉固定用于治疗无神经损伤胸椎骨折能够缩短手术、住院时间,减小手术创口,减少术中出血量,减轻疼痛感,改善后凸Cobb角及伤椎前缘高度,减少并发症发生。Objective To compare the clinical effects of percutaneous and open pedicle screw fixation in the treatment of thoracic vertebral fracture without nerve injury.Methods A total of 86 patients with thoracic vertebral fracture without nerve injury admitted to Henan Provincial Thoracic Hospital from March 2021 to September 2022 were randomly divided into the study group(N=43)and the control group(N=43)according to the random number table.The control group was treated with open pedicle screw fixation.The study group was treated with percutaneous pedicle screw fixation.Perioperative indexes,pain degree[VAS score],kyphosis Cobb angle,the height of the anterior edge of the injured vertebra and its complications were compared.Results Compared with the control group,the operation and hospitalization time and incision length of the study group were shorter,the difference was statistically significant(P<0.05).The VAS score of the two groups decreased significantly after operation,the difference was statistically significant(P<0.05).The VAS score of the study group was lower than that of the control group,the difference was statistically significant(P<0.05).After operation,the kyphotic Cobb angle of the two groups decreased significantly,the difference was statistically significant(P<0.05).The height of the anterior edge of the injured vertebrae increased significantly,the difference was statistically significant(P<0.05),but there was no significant difference in the Cobb angle of the kyphosis and the height of the anterior edge of the injured vertebrae between the study group and the control group(P>0.05).The incidence of complications in the study group(6.98%)was lower than that in the control group(23.26%),and the difference was statistically significant(P<0.05).Conclusion Compared with open pedicle screw fixation,percutaneous pedicle screw fixation for the treatment of thoracic vertebral fracture without nerve injury can shorten the time of operation and hospitalization,reduce the surgical wound,reduce the amount of intrao

关 键 词：无神经损伤 胸椎骨折 经皮椎弓钉固定 开放椎弓钉固定 

分 类 号：R683.1[医药卫生—骨科学]