改良Wiltse入路椎弓根钉内固定术治疗无神经损伤胸腰椎骨折患者的效果  

Effect of Modified Wiltse Approach for Pedicle Screw Internal Fixation in Curing Rehabilitation of Patients with Thoracolumbar Fractures Without Nerve Injury

作　　者：刘明军[1] LIU Mingjun(Department of Orthopedics,Puyang People’s Hospital,Puyang 457000,China)

机构地区：[1]濮阳市人民医院脊柱外科,河南濮阳457000

出　　处：《河南医学研究》2024年第19期3533-3536,共4页Henan Medical Research

摘　　要：目的探讨改良Wiltse入路椎弓根钉内固定术促进无神经损伤胸腰椎骨折患者康复的临床效果。方法回顾性纳入濮阳市人民医院于2021年1月至2023年1月收治的80例无神经损伤胸腰椎骨折患者资料,患者均接受椎弓根钉内固定术治疗,将接受经皮椎弓入路治疗的患者资料纳入对照组(38例),将接受改良Wiltse入路治疗的患者资料纳入观察组(42例)。比较两组手术指标、不同时间脊柱矢状面Cobb角、伤椎前缘相对高度、视觉模拟评分法(VAS)评分及Oswestry功能障碍指数(ODI)。结果观察组手术时间、术中出血量、术后住院时间均低于对照组(P<0.05)。两组术后1、3个月时Cobb角较术前降低,伤椎前缘相对高度较术前升高,Cobb角与伤椎前缘相对高度水平时间效应有统计学意义(P<0.05);两组的组间、交互效应无统计学意义(P>0.05)。两组VAS评分组间、时间、交互效应有统计学意义(P<0.05);观察组术后1个月VAS评分低于对照组,且术后1、3个月时VAS评分较术前降低(P<0.05)。ODI指数时间效应有统计学意义(P<0.05);术后1、3个月时ODI指数较术前降低(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论改良Wiltse入路与经皮椎弓根钉内固定术治疗无神经损伤胸腰椎骨折患者效果相当,两种入路方式均有较高的安全性,但相较于经皮入路,改良Wiltse入路的手术时间更短,术中出血量更少,患者恢复更快,可缓解患者术后短期疼痛程度,促进患者康复。Objective To explore the clinical effect of modified Wiltse approach pedicle screw internal fixation in curing the rehabilitation of patients with thoracolumbar fractures without nerve injury.Methods The clinical data of 80 patients with thoracolumbar fractures without nerve injury admitted to Puyang People’s Hospital from January 2021 to January 2023 were retrospectively included.All the patients enrolled were treated with pedicle nailing,patient data treated with percutaneous pedicle approach were included in the control group(38 cases),and patients treated with modified Wiltse approach were included in the observation group(42 cases).The surgical index,sagittal plane Cobb angle of spine,relative height of the anterior edge of the injured vertebra,visual analogue score(VAS)and Oswestry dysfunction index(ODI)were compared between the two groups.Results The observation group had lower surgical time,intraoperative bleeding volume,and postoperative hospital stay compared to the control group(P<0.05).In both groups,Cobb angle decreased at 1 and 3 months after the operation,and the relative height of the leading edge increased than before the operation,the time effect of Cobb angle and the relative height of the anterior edge was statistically significant(P<0.05).The group and interaction effects of two groups were not statistically significant(P>0.05).There were statistical significant differences in the inter group,time,and interaction effects between the two groups of VAS scores(P<0.05).The VAS scores of the observation group were lower than those of the control group,and the VAS scores decreased compared to preoperative levels at one and three months after surgery(P<0.05).The time effect of ODI index had statistically significance(P<0.05).The ODI index decreased compared to preoperative levels at 1 and 3 months after surgery(P<0.05).There was no statistical significant in the incidence of postoperative complications between two groups(P>0.05).Conclusion The modified Wiltse approach and percutaneous pedicle scre

关 键 词：胸腰椎骨折 改良Wiltse入路 经皮入路 椎弓根钉内固定 

分 类 号：R687.3[医药卫生—骨科学]