微创经皮椎弓根螺钉联合显微镜单侧入路双侧减压术治疗伴神经损伤的胸腰段椎体爆裂骨折临床研究  

Clinical Study on Minimally Invasive Percutaneous Pedicle Screw Fixation Combined with Microsurgical Unilateral Approach Bilateral Decompression for Thoracolumbar Burst Fractures with Neurological Injury

作　　者：吴英添 WU Yingtian(Department of Orthopedics,The Second Hospital of Sanming City,Sanming 366000,china)

机构地区：[1]三明市第二医院骨科,福建三明366000

出　　处：《中华灾害救援医学》2024年第11期1313-1317,共5页Chinese Journal of Disaster Medicine

摘　　要：目的分析微创经皮椎弓根螺钉联合显微镜通道下单侧入路双侧减压手术,治疗伴有神经功能损害的胸腰段椎体爆裂骨折的临床疗效。方法选取2020年10月至2023年10月三明市第二医院骨科收治的80例伴有神经功能损害的胸腰段椎体爆裂骨折患者。以随机数字法分为两组,其中对照组40例给予开放手术治疗,观察组20例给予微创经皮椎弓根螺钉联合显微镜通道下单侧入路双侧减压手术,比较治疗效果。结果观察组术中出血量以及切口长度均低于对照组(P<0.05);观察组术后6个月的ODI评分低于对照组(P<0.05);两组患者治疗后,伤椎、神经功能缺损程度均较治疗前有所改善,且观察组改善效果更好(P<0.05);观察组骨折愈合、下床活动、疼痛缓解时间比对照组低(P<0.05)。结论对伴有神经功能损害的胸腰段椎体爆裂骨折患者,实施微创经皮椎弓根螺钉联合显微镜通道下单侧入路双侧减压手术,能够显著改善患者临床症状,加快患者术后康复,临床应用价值显著。Objective To analyze the clinical efficacy of minimally invasive percutaneous pedicle screw fixation combined with unilateral approach bilateral decompression surgery under a microscope for the treatment of thoracolumbar burst fractures with neurological deficits.Methods A total of 80 patients with thoracolumbar burst fractures and neurological deficits,treated at the Department of Orthopedics,Second Hospital of Sanming City,from October 2020 to October 2023,were enrolled in this study.The patients were randomly divided into two groups:the control group(n=40),who underwent open surgery,and the observation group(n=40),who received minimally invasive percutaneous pedicle screw fixation combined with unilateral approach bilateral decompression under a microscope.The treatment outcomes were compared between the two groups.Results The observation group had significantly less intraoperative blood loss and shorter incision length compared to the control group(P<0.05).At 6 months postoperatively,the observation group had a lower Oswestry Disability Index(ODI)score compared to the control group(P<0.05).Both groups showed improvements in vertebral injury and neurological function post-treatment,with the observation group demonstrating greater improvements(P<0.05).Additionally,the observation group had a shorter time to fracture healing,ambulation,and pain relief compared to the control group(P<0.05).Conclusion Minimally invasive percutaneous pedicle screw fixation combined with unilateral approach bilateral decompression under a microscope significantly improves clinical symptoms and accelerates postoperative recovery in patients with thoracolumbar burst fractures and neurological deficits,demonstrating significant clinical value.

关 键 词：微创经皮椎弓根螺钉 单侧入路双侧减压 胸腰段椎体爆裂骨折 

分 类 号：R274.1[医药卫生—中医骨伤科学]