经皮微创椎弓根螺钉内固定术与开放椎弓根螺钉内固定术治疗老年脊柱骨折患者的效果比较  

Comparison of effects of percutaneous minimally invasive pedicle screw internal fixation and open pedicle screw internal fixation in treatment of elderly patients with spinal fractures

作　　者：陈凡州 张岐 CHEN Fanzhou;ZHANG Qi(1^(st)Department of Orthopaedics of the Third Affiliated Hospital of Nanyang Medical College,Nanyang 473000 Henan,China;1^(st)Department of Orthopaedics OF Nanzhao Hongyu Hospital,Nanyang 473000 Henan,China)

机构地区：[1]南阳医学高等专科学校第三附属医院骨一科,河南南阳473000 [2]南召红宇医院骨一科,河南南阳473000

出　　处：《中国民康医学》2024年第24期141-144,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较经皮微创椎弓根螺钉内固定术与开放椎弓根螺钉内固定术治疗老年脊柱骨折患者的效果。方法:选取2021年1月至2023年10月南阳医学高等专科学校第三附属医院收治的80例老年脊柱骨折患者进行前瞻性研究,按随机数字表法将其分为对照组(n=40)与观察组(n=40)。对照组采用开放椎弓根螺钉内固定术治疗,观察组采用经皮微创椎弓根螺钉内固定治疗。比较两组围术期指标(手术时间、手术切口、术中出血量、术后卧床时间、术后住院时间)水平,手术前后影像学指标[脊柱后凸角度(Cobb)、矢状面指数(SI)、椎体前缘高度]水平、疼痛应激反应指标[血清P物质(SP)、皮质醇(Cor)、白细胞介素-6(IL-6)]水平、脊柱功能[Oswestry功能障碍指数(ODI)]评分、日常生活能力[日常生活活动能力(ADL)]评分,以及术后并发症发生率。结果:观察组手术时间、手术切口、术后卧床时间、术后住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3个月,两组Cobb角均小于治疗前,且观察组小于对照组,两组SI、椎体前缘高度均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后3 d,两组SP、Cor、IL-6水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后3个月,两组ODI评分均低于术前,且观察组低于对照组,两组ADL评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:经皮微创椎弓根螺钉内固定术治疗老年脊柱骨折患者可提高日常生活能力评分,改善影像学指标、围术期指标水平,以及降低应激反应指标水平、脊柱功能障碍评分和并发症发生率的效果优于开放椎弓根螺钉内固定术治疗。Objective:To compare effects of percutaneous minimally invasive pedicle screw internal fixation and open pedicle screw internal fixation in treatment of elderly patients with spinal fractures.Methods:A prospective study was conducted on 80 elderly patients with spinal fractures admitted to the third affiliated hospital of Nanyang medical college from January 2021 to October 2023.They were divided into control group(n=40)and observation group(n=40)by using the random number table method.The control group was treated with open pedicle screw internal fixation,while the observation group was treated with percutaneous minimally invasive pedicle screw internal fixation.The perioperative indexes(operation time,surgical incision,intraoperative blood loss,postoperative bed rest time,postoperative hospitalization time)levels,the imaging indexes[kyphosis angle(Cobb),sagittal index(SI),anterior vertebral height]levels,the pain stress response indexes[serum substance P(SP),cortisol(Cor),interleukin-6(IL-6)]levels,the spinal function[Oswestry dysfunction index(ODI)]score,the activities of daily living[activity of daily living(ADL)]score before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:The operation time,surgical incision,postoperative bed rest time and postoperative hospitalization time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the Cobb angle of the two groups were smaller than those before the treatment,and that in the observation group was smaller than that in the control group;the levels of SI and anterior vertebral height in the two groups were higher than those before the surgery,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of SP,Cor

关 键 词：老年 脊柱骨折 经皮微创椎弓根螺钉内固定术 开放椎弓根螺钉内固定术 脊柱功能 日常生活能力评分 疼痛 

分 类 号：R687.3[医药卫生—骨科学]