不同入路椎弓根螺钉内固定联合伤椎置钉治疗胸腰椎段脊柱骨折的临床对比  

Clinical comparison of different approaches of pedicle screw fixation combined with screw placement of injured vertebrae in the treatment of thoracolumbar spine fractures

作　　者：翟应年 崔钢华 王永 ZHAI Ying-nian;CUI Gang-hua;WANG Yong(Second Ward,Department of Orthopaedics,Dengzhou People'Hospital Dengzhou,Henan 474150,China)

机构地区：[1]邓州市人民医院骨外科二病区,河南邓州474150

出　　处：《医药论坛杂志》2023年第3期75-78,82,共5页Journal of Medical Forum

摘　　要：目的 对胸腰椎段脊柱骨折患者采用不同入路椎弓根螺钉内固定联合伤椎置钉治疗的临床效果进行对比和讨论。方法 本次研究对象均选自邓州市人民医院骨外科于2019年12月—2021年12月收治的84例胸腰椎段脊柱骨折患者,采用奇偶数分配的方式将患者平均分为对照组(n=42例)和观察组(n=42例)。在研究过程中,两组胸腰椎段脊柱骨折患者均采用椎弓根螺钉内固定联合伤椎置钉治疗,对照组选择传统后正中入路的方式,观察组选择椎旁肌间隙入路的方式。记录和比较两组患者的手术期指标以及随访期间并发症的发生情况;分别于术前、术后3个月记录两组患者活动时的脊椎疼痛程度、椎体前缘高度和Cobb角并对比。结果 观察组的手术持续时间为(107.10±9.86)min、术中出血量为(44.48±7.26)mL、术后引流量为(82.40±9.24)mL、住院时间为(11.69±3.08)d,均低于对照组,差异有统计学意义(P<0.05);术后3个月观察组的VAS评分为(2.07±0.68)分,低于对照组,差异有统计学意义(P<0.05);术后对照组与观察组的椎体前缘高度分别为(85.24±6.41)%、(83.29±6.48)%,Cobb角分别为(7.57±1.13)°、(7.50±1.13)°,两组对比差异均无统计学意义(P>0.05);随访期间两组患者均未发生并发症。结论 与传统后正中入路相比,胸腰椎段脊柱骨折患者采用椎旁肌间隙入路椎弓根螺钉内固定联合伤椎置钉治疗的临床效果更好,更能有效的降低疼痛,促进患者恢复。Objective To compare and discuss the clinical effects of different approaches of pedicle screw fixation combined with screw placement of injured vertebrae in the treatment of thoracolumbar spine fractures. Methods Totally 84 patients with thoracolumbar spine fractures were selected from the Department of Orthopaedics, Dengzhou People’ Hospital of Henan Province from December 2019 to December 2021. The patients were divided into control group(n=42 cases) and observation group(n=42 cases) by odd and even number distribution. In the course of the study, both groups of patients with thoracolumbar spine fractures were treated with pedicle screw internal fixation combined with screw placement of injured vertebrae. The control group chose the traditional posterior median approach, and the observation group chose the paravertebral muscle space approach. The indexes during operation and complications during follow-up were recorded and compared between the two groups;The degree of spinal pain, the height of anterior vertebral body and Cobb angle of patients in both groups were recorded and compared before operation and 3 months after operation. Results In the observation group, the operation duration was(107.10±9.86) min, the intraoperative bleeding amount was(44.48±7.26) mL, the postoperative drainage volume was(82.40±9.24) mL, and the hospitalization time was(11.69±3.08) d, which were significantly lower than those in the control group, the difference was statistically significant(P<0.05);3 months after operation, the VAS score of the observation group was(2.07±0.68), which was lower than that of the control group, the difference was statistically significant(P<0.05);The height of the anterior edge of the vertebral body in the control group and the observation group were(85.24±6.41)% and(83.29±6.48)% respectively, and the Cobb angle was(7.57±1.13) ° and(7.50±1.13) ° respectively, there was no statistical significant difference between the two groups(P>0.05);During the follow-up, no complications occurred in

关 键 词：胸腰椎脊柱骨折 伤椎置钉 椎弓根螺钉内固定 

分 类 号：R683.2[医药卫生—骨科学]