摘要
目的:观察经皮微创内固定术治疗胸腰椎压缩性骨折患者的效果。方法:选取2020年1月至2021年3月该院收治的92例胸腰椎压缩性骨折患者进行前瞻性研究,以随机数字表法分为对照组和观察组各46例。对照组使用开放性椎弓根螺钉内固定术治疗,观察组使用经皮微创椎弓根螺钉内固定术治疗,比较两组围术期指标(手术时间、术中出血量、下床活动时间、住院时间、骨折愈合时间)水平、手术前后影像学指标(椎体前缘高度、椎间隙高度、Cobb角、Worter指数)水平、疼痛[视觉模拟评分法(VAS)]评分、Oswestry功能障碍指数(ODI)评分、生命质量[健康调查简表(SF-36)]评分和术后3个月并发症发生率。结果:观察组手术时间、下床活动时间、住院时间和骨折愈合时间均短于对照组,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,两组椎体前缘高度和椎间隙高度均高于术前,Cobb角和Worter指数均小于术前,但组间比较,差异无统计学意义(P>0.05);术后7 d,观察组VAS评分低于对照组,差异有统计学意义(P<0.05);术后3个月,观察组ODI评分低于对照组,SF-36评分高于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为4.35%(2/46),低于对照组的19.57%(9/46),差异有统计学意义(P<0.05)。结论:经皮微创内固定术治疗胸腰椎压缩性骨折患者可提高SF-36评分,改善围术期指标水平,降低VAS评分、ODI评分和并发症发生率,效果优于开放性椎弓根螺钉内固定术治疗。
Objective:To observe effects of percutaneous minimally invasive internal fixation in treatment of patients with thoracolumbar vertebral compression fractures.Methods:92 patients with thoracolumbar vertebral compression fractures who were treated in our hospital from January 2020 to March 2021 were selected for the prospective study and were divided into control group and observation group by using the random number table method,46 cases in each group.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 indicator levels[operation time,intraoperative blood loss,out-of-bed activity time,hospitalization time,fracture healing time],the imaging indicator scores before and after the surgery[anterior vertebral height,intervertebral space height,Cobb angle,Worter Index],the pain[visual analogue scale(VAS)]score,the Oswestry disability index(ODI)score,the quality of life[short form health survey(SF-36)]score,and the incidence of 3-month postoperative complications were compared between the two groups.Results:The operation time,the out-of-bed activity time,the hospitalization time and the fracture healing time of the observation group were shorter than those of the control group;the intraoperative blood loss was less than that of the control group;and the differences were statistically significant(P<0.05).3 months after the surgery,the anterior vertebral height and the intervertebral space height in both groups were higher than those before the surgery,and the Cobb angle and the Worter index were lower than those before the surgery;however,there were no significant differences between the two groups(P>0.05).7th day after the surgery,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).3 months after the surgery,the ODI score in the observation group was lower than that in the control group,the SF-36 score in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 4.35%(2/46),which was lower than 19.57%(9/46)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Percutaneous minimally invasive internal fixation in the treatment of the patients with thoracolumbar compression fractures can increase the SF-36 scores,improve the perioperative index levels,and reduce the VAS scores,the ODI scores and the incidence of complications.Moreover,it is superior to open pedicle screw fixation.
作者
曲良烨
QU Liangye(Department of Orthopedics of Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000 Henan,Chin)
出处
《中国民康医学》
2022年第14期58-61,共4页
Medical Journal of Chinese People’s Health
关键词
胸腰椎压缩性骨折
经皮微创内固定术
腰椎功能
生命质量
并发症
Thoracolumbar vertebral compression fracture
Percutaneous minimally invasive internal fixation
Lumbar function
Quality of life
Complication
