后入路与前入路内固定融合术治疗老年骨质疏松性脊柱骨折的效果  

Effect of Posterior Approach and Anterior Approach Internal Fixation Fusion on Senile Osteoporotic Spinal Fracture

作　　者：戴磊 DAI Lei(Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 451162,China)

机构地区：[1]郑州大学第一附属医院骨科,河南郑州451162

出　　处：《河南医学研究》2025年第3期440-443,共4页Henan Medical Research

摘　　要：目的 研究不同入路内固定融合术治疗老年骨质疏松性脊柱骨折的效果。方法 以2021年4月至2023年4月郑州大学第一附属医院医治的107例老年骨质疏松性脊柱骨折患者为研究对象,依据入路方式分为后入路组(55例)、前入路组(52例),后入路组接受后入路内固定融合术,前入路组接受前入路内固定融合术。比较两组手术指标、手术前后脊柱功能、骨代谢指标[骨钙素(BGP)、Ⅰ型前胶原氨基末端前肽(PⅠCP)、骨保护素(OPG)]、术后脊髓神经功能、疼痛程度及并发症状况。结果 与前入路组相比,后入路组出血量较少,手术时间、住院时间、切口愈合时间均较短(P<0.05);术后与前入路组相比,后入路组疼痛评分和脊柱功能评分较低(P<0.05);与前入路组相比,术后3个月后入路组血清BGP、PⅠCP、OPG水平较高(P<0.05);术后3个月,两组脊髓神经功能比较,差异无统计学意义(P>0.05);两组并发症发生率(1.82%比7.69%)相比,差异无统计学意义(P>0.05)。结论 老年骨质疏松性脊柱骨折患者接受后入路内固定融合术能促进脊柱功能快速恢复,改善骨代谢指标,减轻术后疼痛感,加快康复进程。Objective To investigate the effects of different approaches of internal fixation and fusion in the treatment of senile osteoporotic spinal fractures.Methods A total of 107 elderly patients with osteoporotic spinal fracture treated in the First Affiliated Hospital of Zhengzhou University from April 2021 to April 2023 were divided into posterior approach group(55 cases)and anterior approach group(52 cases)according to approaches.Posterior approach group underwent posterior approach internal fixation fusion,and anterior approach group underwent anterior approach internal fixation fusion.The surgical indexes,spinal function before and after surgery,bone metabolism indexes[bone gla protein(BGP),procollagenⅠN-terminal propeptide(PⅠCP),osteoprotegerin(OPG)],postoperative spinal nerve function,pain degree and complications were compared between the two groups.Results Compared with the anterior approach group,the posterior approach group had less bleeding,shorter operative time,shorter hospitalization time,and shorter wound healing time(P<0.05).Postoperative pain scores and spinal function scores in the posterior approach group were lower than those in the anterior approach group(P<0.05).The levels of serum BGP,PⅠCP and OPG in the approach group were higher than those in the former approach group 3 months after operation(P<0.05).Three months after surgery,there was no significant difference in spinal nerve function between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(1.82%vs 7.69%)(P>0.05).Conclusion Posterior internal fixation and fusion in elderly patients with osteoporotic spinal fracture can promote rapid recovery of spinal function,improve bone metabolism index,reduce postoperative pain and accelerate rehabilitation process.

关 键 词：脊柱骨折 内固定融合术 疼痛程度 脊柱功能 骨代谢 脊髓神经功能 

分 类 号：R683[医药卫生—骨科学]