摘要
目的观察不同入路微创椎弓根钉内固定术治疗胸腰椎创伤性骨折的临床效果。方法回顾2016年6月至2019年7月间于本院就诊的72例发生胸腰椎创伤性骨折的患者病例,按手术入路方式分为A、B组各36例。两组均接受椎弓根钉内固定术治疗,A组经肌间隙入路,B组经皮入路。观察两组手术情况、疼痛评分、伤椎恢复、术后并发症。结果A组手术时长、术中透视时长短于B组,A组术中出血量、术后24 h引流量均高于B组,A组下床时间、住院时间均久于B组(P<0.05);A组术后3 d、7 d的视觉模拟疼痛评分高于B组(P<0.05);A组伤椎Cobb’s角、伤椎前缘高度比、椎间隙高度与B组比较,差异无统计学意义(P>0.05);直至末次随访,两组并发症发生率比较,差异无统计学意义(P>0.05)。结论两种入路方案对胸腰椎创伤性骨折患者均有较好疗效,经皮入路微创椎弓根钉内固定术更有利于患者术后恢复,手术创口更小,给患者带来的疼痛感更轻。
Objective To observe the clinical effect of different approaches of minimally invasive pedicle screw internal fixation in the treatment of traumatic thoracolumbar fractures.Methods A review of 72 patients with traumatic thoracolumbar spine fractures in our hospital from June 2016 to July 2019 were reviewed.According to the surgical approach,they were divided into groups A and B with 36 cases in each group.Both groups received pedicle screw internal fixation,group A was approached through the intermuscular space,and group B was approached through the skin.The operation status,pain score,recovery of injured vertebrae and postoperative complications were observed in the two groups.Results The operation time and intraoperative fluoroscopy time of group A were shorter than those of group B.The blood loss and 24 h drainage volume of group A were higher than those of group B.The time to get out of bed and hospital stay in group A were longer than those of group B(P<0.05).The visual analog pain scores of group A were higher than those of group B at 3 and 7 days after operation(P<0.05).Compared with group B,the Cobb's angle,the height ratio of the anterior edge of the injured vertebra and the height of the intervertebral space in group A were not statistically different Significance(P>0.05).Until the last follow-up,there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Both approaches have good curative effects on patients with thoracolumbar traumatic fractures.The minimally invasive percutaneous pedicle screw internal fixation is more conducive to the postoperative recovery of the patients,and the surgical wound is smaller,which brings the patients.The pain is lighter.
作者
欧阳利云
唐颖
上官文峰
刘成业
OUYANG Liyun(Department of Orthopedics,Luoyang Oriental Hospital,Luoyang 471003,China)
出处
《牡丹江医学院学报》
2021年第1期102-104,108,共4页
Journal of Mudanjiang Medical University
基金
洛阳市级医疗卫生科技计划项目(1930006A)。
关键词
胸腰椎创伤性骨折
VAS评分
经皮入路
经肌间隙入路
Thoracolumbar traumatic fracture
VAS score
Percutaneous approach
Transmuscular approach
