不同方位经伤椎椎弓根螺钉置入内固定治疗腰椎骨折的远期效果比较研究  

A comparative study on the long-term effect of pedicle screw fixation in different directions of injured vertebrae in the treatment of lumbar fractures

作　　者：李挺 陈明亮 丁立林 LI Ting;CHEN Ming-liang;DING Li-lin(Orthopedics Department,Nancheng County People's Hospital,Fuzhou 344700,China)

机构地区：[1]南城县人民医院骨科,344700

出　　处：《中国现代药物应用》2024年第15期44-47,共4页Chinese Journal of Modern Drug Application

基　　金：江西省卫生健康委科技计划(项目编号:202312417)。

摘　　要：目的比较不同方位经伤椎椎弓根螺钉置入内固定治疗腰椎骨折的远期效果。方法62例腰椎骨折患者,根据手术方式不同分为A组(32例)和B组(30例)。A组接受单侧椎弓根螺钉置入内固定,B组接受双侧椎弓根螺钉置入内固定。比较两组手术时间、术中出血量,手术前后Oswestry功能障碍指数(ODI)、伤椎前缘高度比(AVBH%)、伤椎矢状位Cobb's角(SCA),术后并发症发生率。结果两组术后1周、术后半年ODI评分均低于本组术前,差异具有统计学意义(P<0.05)。两组ODI评分在术前、术后1周、术后半年重复测量组间比较差异无统计学意义(F=0.339,P=0.561>0.05);具有时间效应(F=4050.000,P=0.000<0.05);时间与组别之间无交互效应(F=2.036,P=0.132>0.05)。A组手术时间和术中出血量分别为(98.42±14.61)min、(184.55±22.12)ml,均少于B组的(252.24±32.15)min、(325.02±35.42)ml(t=24.510、18.857,P=0.000、0.000<0.05)。两组术后1周、1个月、3个月、半年的AVBH%较本组术前增加,SCA较本组术前降低,且A组AVBH%高于B组,SCA低于B组(P<0.05)。两组AVBH%在术前及术后1周、1个月、3个月、半年重复测量组间比较差异无统计学意义(F=1.202,P=0.274>0.05);具有时间效应(F=280.400,P=0.000<0.05);时间与组别之间有交互效应(F=14.420,P=0.000<0.05);两组SCA在术前及术后1周、1个月、3个月、半年重复测量组间比较差异有统计学意义(F=65.410,P=0.000<0.05);具有时间效应(F=484.300,P=0.000<0.05);时间与组别之间有交互效应(F=9.940,P=0.000<0.05)。A组术后并发症发生率为3.13%(1/32),显著低于B组的20.00%(6/30)(χ^(2)=4.402,P=0.036<0.05)。结论经伤椎单侧置钉与双侧置钉对腰椎骨折患者腰椎功能的恢复效果类似,但单侧置钉复位伤椎并长期维持椎体高度的效果更显著,并发症发生率更低,值得推广应用。Objective To compare the long-term effect of pedicle screw fixation in different directions of injured vertebrae in the treatment of lumbar fractures.Methods 62 patients with lumbar fracture were divided into group A(32 cases)and group B(30 cases)according to different surgical methods.Group A received unilateral pedicle screw fixation,and group B received bilateral pedicle screw fixation.Comparison was made on operative time,intraoperative blood loss,Oswestry disability index(ODI),anterior vertebral body height(AVBH%),sagittal Cobb's angle(SCA)and postoperative complications between the two groups.Results The ODI scores of the two groups at 1 week and 6 months after surgery were lower than those before surgery,and the difference was statistically significant(P<0.05).There was no significant difference in ODI scores between the two groups before surgery,at 1 week and 6 months after surgery(F=0.339,P=0.561>0.05);there was a time effect(F=4050.000,P=0.000<0.05);and there was no interaction effect between time and group(F=2.036,P=0.132>0.05).The operative time and intraoperative blood loss in group A were(98.42±14.61)min and(184.55±22.12)ml,which were less than(252.24±32.15)min and(325.02±35.42)ml in group B(t=24.510,18.857;P=0.000,0.000<0.05).At 1 week,1 month,3 months and 6 months after surgery,the AVBH%in the two groups increased and SCA decreased compared with this group before surgery;AVBH%in group A was higher than that in group B,and SCA was lower than that in group B(P<0.05).There was no significant difference in AVBH%between the two groups before surgery and at 1 week,1 month,3 months and 6 months after surgery(F=1.202,P=0.274>0.05);there was a time effect(F=280.400,P=0.000<0.05);and there was an interaction effect between time and group(F=14.420,P=0.000<0.05).The difference between the two groups of SCA before surgery and at 1 week,1 month,3 months and 6 months after surgery was statistically significant(F=65.410,P=0.000<0.05);there was a time effect(F=484.300,P=0.000<0.05);and there was an interaction

关 键 词：单侧椎弓根螺钉 双侧椎弓根螺钉 腰椎骨折 远期效果 

分 类 号：R687.3[医药卫生—骨科学]