经后路伤椎椎弓根钉固定治疗胸腰椎爆裂骨折的疗效观察

目的:探讨经后路伤椎椎弓根钉固定治疗胸腰椎爆裂骨折的临床疗效及安全性。方法:择取2014年1月至2016年12月我院收治的64例胸腰椎爆裂骨折患者,将其均分为研究组(n=32)与对照组(n=32)。研究组采用经后路伤椎椎弓根钉固定治疗,对照组采用经后路非伤椎置钉短节段椎弓根钉固定治疗,治疗后随访6个月。比较两组临床指标、并发症发生情况以及术前、术后1个月、6个月伤椎前缘高度比、Cobb角、疼痛数字评分量表(NRS)评分。结果:两组患者手术切口均实现I期愈合,术后无感染。与对照组相比,研究组手术时间较长(P0.05),术中出血量、住院时间比较无统计学差异(P0.05)。两组术前伤椎前缘高度比、Cobb角、NRS评分比较无统计学意义(P0.05);术后1个月、术后6个月两组伤椎前缘高度比较术前显著升高,Cobb角、NRS评分较术前显著降低,差异有统计学意义(P0.05)。术后6个月研究组Cobb角、NRS评分低于对照组(P0.05),两组伤椎前缘高度比比较无统计学意义(P0.05)。与对照组相比,研究组术后腰背痛、内固定失败发生率均较低(P0.05)。结论:对于胸腰椎爆裂骨折患者,经后路伤椎椎弓根钉固定可以有效改善临床指标,有利于术后身体恢复,减轻疼痛,安全性较高,值得临床推广。

Curative Effect of Thoracolumbar Burst Fracture Treatment with Posterior Vertebral Pedicle Screw Fixation

ABSTRACT Objective: To explore the clinical efficacy and safety of posterior vertebral pedicle screw fixation in the treatment of thoracolumbar burst fracture. Methods: 64 cases of thoracolumbar burst fracture treated in our hospital from January 2014 to December 2016 were selected,which were divided into study group (n=32) and control group (n=32). The study group was treated by posterior vertebral pedicle screw fixation, the control group was treated by posterior vertebral pedicle screw pedicle screw fixation. The patients were followed up for 6 months. The clinical indicators, complications were compared between the two groups. The height ratio of anterior margin of injured vertebra, Cobb angle and Numeric Pain Rating Scale (NRS) scores of the two groups before operation,1 month after operation, 6 months after operation were compared. Results: All the patients were all healed in I stage and no infection after operation. Compared with the control group, the operation time of the study group was longer (P<0.05), and there was no significant difference between the amount of bleeding and the time of hospitalization (P>0.05). There was no significant difference between the height ratio of anterior margin of injured vertebra, Cobb angle and NRS scores of the two groups (P>0.05). 1 month after operation, 6 months after operation, the height ratio of anterior margin of injured vertebra in the two groups were higher than before operation, Cobb angle and NRS scores were lower than before operation, the differences were statistically significant (P<0.05). 6 months after operation, the Cobb angle, NRS scores in the study group were lower than that in the control group (P<0.05), and there was no significant difference in the height ratio of anterior margin of injured vertebra of the two groups (P>0.05). Compared with the control group, the incidence rate of lumbago and back pain and internal fixation failure in the study group were lower than that in the control group (P<0.05). Conclusion: For thoracolumbar burst fractures,posterior vertebral pedicle screw fixation can effectively improve clinical indicators, is conducive to postoperative physical recovery,pain relief and safety, and is worthy of clinical promotion.