微创经皮椎弓根螺钉固定与开放式椎弓根螺钉固定治疗A2、A3型胸腰椎骨折的效果对比  

Comparison of Minimally Invasive Percutaneous Pedicle Screw Fixation and Open Pedicle Screw Fixation in the Treatment of A2 and A3 Thoracolumbar Fractures

作　　者：徐修磊 周刚[1] 宋杰 张晓锐 Xu Xiulei;Zhou Gang;Song Jie;Zhang Xiaorui(Department of Orthopedics Ward Ⅱ,Xinjiang Production and Construction Corps First Division Aral Hospital,Alar 843300,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆生产建设兵团第一师阿拉尔医院骨科二病区,新疆维吾尔自治区阿拉尔843300

出　　处：《中外医药研究》2023年第17期64-66,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：第一师阿拉尔市科技计划项目(编号:2021YL07)。

摘　　要：目的:分析微创经皮椎弓根螺钉固定与开放式椎弓根螺钉固定在A2、A3型胸腰椎骨折中的治疗效果。方法:选取2021年9月—2022年9月新疆生产建设兵团第一师阿拉尔医院收治的A2、A3型胸腰椎骨折患者66例为观察对象,按照切开复位内固定方式不同将患者分为微创组(33例,微创经皮椎弓根螺钉固定治疗)与开放组(33例,开放式椎弓根螺钉固定治疗)。比较两组患者临床治疗效果。结果:术后48 h,微创组C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平均低于开放组,差异有统计学意义(P=0.001);末次随访,两组患者VAS评分、Oswestry功能障碍指数均降低,微创组低于开放组,差异有统计学意义(P=0.001);末次随访,两组患者后凸Cobb's均降低,椎体矢状径、椎体前缘高度比均提高,微创组优于开放组,差异有统计学意义(P<0.05)。结论:A2、A3型胸腰椎骨折患者微创经皮椎弓根螺钉固定治疗效果优于开放式椎弓根螺钉固定治疗,可改善术后炎性指标,快速恢复椎体功能,降低疼痛程度。Objective:To analyze the efficacy of minimally invasive percutaneous pedicle screw fixation and open pedicle screw fixation in the treatment of A2 and A3 thoracolumbar fractures.Methods:A total of sixty-six patients with type A2 and A3 thoracolumbar fracture admitted to the Xinjiang Production and Construction Corps First Division Aral Hospital from September 2021 to September 2022 were selected as the observation objects.According to different methods of open reduction and internal fixation,the patients were divided into minimally invasive group(33 cases,minimally invasive percutaneous pedicle screw fixation)and open group(33 cases,open pedicle screw fixation treatment).The clinical therapeutic effect of the two groups was compared.Results:48 h after surgery,the levels of C-reactive protein,tumor necrosis factor-α and interleukin-6 in the minimally invasive group were lower than those in the open group,with statistical significance(P=0.001);At the last follow-up,VAS score and Oswestry disability index were decreased in both groups,and the minimally invasive group was lower than the open group,with statistical significance(P=0.001);At the last follow-up,kyphotic Cobb's decreased in both groups,while sagittal diameter and anterior vertebral margin height ratio increased in both groups,and the minimally invasive group was superior to the open group,with statistical significance(P<0.05).Conclusion:The effect of minimally invasive percutaneous pedicle screw fixation on patients with A2 and A3 thoracolumbar fractures is better than that of open pedicle screw fixation,which can improve postoperative inflammatory indicators,quickly restore vertebral function,and reduce pain degree.

关 键 词：胸腰椎骨折 微创经皮椎弓根螺钉 椎弓根螺钉固定 切开复位内固定 末次随访 观察对象 矢状径 炎性指标 

分 类 号：R68[医药卫生—骨科学]