经皮微创椎弓根螺钉内固定术对骨质疏松脊柱压缩性骨折患者临床研究  

Clinical study on percutaneous minimally invasive pedicle screw fixation for patients with osteoporotic spinal compression fractures

作　　者：谭明明 战世强 侯宏涛 曾翔硕 Tan Mingming;Zhan Shiqiang;Hou Hongtao;Zeng Xiangshuo(Department of Orthopedic,Jiamusi Orthopedic Hospital,Jiamusi 154000,China)

机构地区：[1]佳木斯骨科医院骨科,154000

出　　处：《中华老年骨科与康复电子杂志》2024年第6期349-354,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：黑龙江省卫生健康委科研课题立项项目(2019-286)。

摘　　要：目的探讨经皮微创椎弓根螺钉内固定术对骨质疏松脊柱压缩性骨折(OVCF)患者椎体功能、组织创伤及血清骨形态发生蛋白-7(BMP-7)和骨钙素N端中分子片段(N-MID)水平影响。方法选择我院于2021年9月至2022年9月收治的OVCF患者83例,依据手术方法分为微创组42例与开放组41例。微创组采用经皮微创椎弓根螺钉内固定术治疗,开放组采用开放椎弓根螺钉内固定术治疗。比较两组术前、术后1个月和术后3个月静息状态和活动状态疼痛视觉模拟评分法(VAS),Oswestry功碍指数问卷表(ODI)评分,伤椎高度百分比和Cobb角;术前和术后48h患者BMP-7和N-MID水平变化。结果微创组和开放组术前OVCF患者静息状态和活动状态VAS评分比较无显著差异(P>0.05);微创组术后1个月和术后3个月OVCF患者静息状态和活动状态VAS评分低于开放组(P<0.05)。微创组术后1个月和术后3个月OVCF患者ODI评分低于开放组(P<0.05)。两组术后1个月和术后3个月OVCF患者伤椎前缘高度高于术前,而Cobb角低于术前(P<0.05);微创组和开放组术后1个月和术后3个月OVCF患者伤椎前缘高度和Cobb角比较无显著差异(P>0.05)。两组术后48 h OVCF患者血清BMP-7和N-MID水平高于术前(P<0.05);微创组术后48 h OVCF患者血清BMP-7和N-MID水平高于开放组(P<0.05)。结论经皮微创椎弓根螺钉内固定术可改善OVCF患者椎体功能,且可提高患者血清BMP-7和N-MID水平,值得临床借鉴。Objective To investigate the effects of percutaneous minimally invasive pedicle screw fixation on vertebral function,tissue trauma and serum levels of bone morphogenetic protein-7(BMP-7)and N-terminal middle molecular fragment of osteocalcin(N-MID)in patients with OVCF.Methods The 83 patients with OVCF admitted to our hospital from September 2021 to September 2022 divided into minimally invasive group(42 cases)and open group(41 cases)according to surgical methods.The minimally invasive group was treated with percutaneous minimally invasive pedicle screw internal fixation,while the open group was treated with open pedicle screw internal fixation.The VAS,ODI score,percentage of injured vertebral height and Cobb angle compared two groups before operation,1 month after operation and 3 months after operation;changes of BMP-7 and N-MID levels in patients before and 48 hours after operation.Results The minimally invasive group and open group VAS scores no difference(P>0.05);minimally invasive group VAS scores of OVCF patients lower than open group(P<0.05).The minimally invasive group ODI score of OVCF patients lower than open group at 1 month and 3 months after operation(P<0.05).Two groups height of the anterior edge of the injured vertebra in OVCF patients higher than before operation,and the Cobb angle lower than before operation(P<0.05);minimally invasive group and the open group anterior edge height and Cobb angle no difference(P>0.05).The two groups after operation 48 hours serum BMP-7 and NMID in OVCF patients higher than before operation(P<0.05);minimally invasive group serum BMP-7 and N-MID in OVCF patients higher than open group(P<0.05).Conclusion Percutaneous minimally invasive pedicle screw fixation can improve the vertebral function of OVCF patients,and improve the serum BMP-7 and N-MID levels of patients,which is worthy of clinical reference.

关 键 词：经皮微创椎弓根螺钉内固定术 骨质疏松 脊柱压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]