经皮微创椎弓根螺钉内固定与开放手术对胸腰椎骨折患者Cobb's 角 与椎体前缘高度恢复的影响

目的:比较经皮微创椎弓根螺钉内固定与开放手术治疗胸腰椎骨折的临床疗效,并对其Cobb's角与椎体前缘高度的变化情况进行比较。方法:选择2011年1月-2013年10月我院收治的60例胸腰椎骨折患者并按照数字随机法分为两组,每组30例,对照组采取开放椎弓根螺钉内固定治疗,观察组经皮微创椎弓根螺钉内固定治疗,两组患者均随访24个月,比较两组患者手术一般情况及Cobb's角与椎体前缘高度恢复情况。结果:观察组手术切口长度、术中出血量及住院时间均短于对照组,差异具有统计学意义(均P0.05)。两组术后伤椎前缘高度及矢状位指数均大于术前(均P0.05),观察组术后伤椎前缘高度及矢状位指数均大于对照组(均P0.05);且两组术后后凸Cobb角小于术前(均P0.05),且观察组术后后凸Cobb角小于对照组(P0.05)。观察组术后并发症1例(3.3%),与对照组4例(13.3%)比较无显著统计学差异(均P0.05)。结论:经皮微创椎弓根螺钉内固定治疗胸腰椎骨折疗效较佳,Cobb's角与椎体前缘高度恢复情况较优。

Impact of Percutaneous Minimally Invasive Pedicle Screw Fixation and Open Surgery on the Cobb Angle and Anterior Height of the Vertebral Body of Patients with Thoracolumbar Fractures

Objective:To compare the clinical effect of minimally invasive percutaneous pedicle screw fixation and open surgery in the treatment of thoracolumbar fractures, and compare the Cobb ''s angle and vertebral height restoration.Methods:60 cases of thoracolumbar fractures treated from January 2011 to October 2013 admitted in our hospital were selected and randomly divided into two groups with 30 cases in each group. The control group took the open pedicle screw fixation while the observation group accepted minimally invasive percutaneous pedicle screw fixation, two patients were followed up for 24 months. The general situation of operation, Cobb''s angle and vertebral height restoration were compared between two groups.Results:The incision length, bleeding volume and hospitalization time of observation group were shorter than those of the control group (P<0.05). The kyphosis Cobb angle and sagittal index of observation groups after operation were higher than those of the control group(P<0.05); the postoperative injury vertebral height and sagittal position index of both groups postoperation were higher than those preoperation, which was significantly higher in the observation group than those of the control group(P<0.05); the postoperative Cobb angle of both groups were less than those preoperation (P<0.05), which was less in the observation group than that of control group (P<0.05). No significant difference was found in the incidence of postoperative complications between two groups.Conclusion:Minimally invasive percutaneous pedicle screw fixation had better curative effect in the treatment of thoracolumbar fracture and Cobb''s angle and anterior vertebral body height recovery better.