| 王云浩,李红星,戴云飞.经皮微创椎弓根螺钉内固定联合后路减压植骨治疗脊柱骨折疗效分析[J].中国烧伤创疡杂志,2025,(1):62~66. |
| DOI： |
| 中文关键词: 脊柱骨折 经皮微创椎弓根螺钉内固定 后路减压植骨 脊髓神经功能 |
| 英文关键词:Spinal fracture Minimally invasive percutaneous pedicle screw fixation Posterior decompression and bone grafting Spinal cord nerve function |
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| 中文摘要: |
| 【摘要】 目的 探讨经皮微创椎弓根螺钉内固定联合后路减压植骨治疗脊柱骨折的临床疗效。 方法 选取2019 年 7 月至 2022 年 7 月郑州市第三人民医院收治的 70 例脊柱骨折患者作为研究对象, 按照不同治疗方法将其分为联合组 (35 例) 和单一组 (35 例), 联合组患者采用经皮微创椎弓根螺钉内固定联合后路减压植骨治疗,单一组患者采用经皮微创椎弓根螺钉内固定治疗, 对比观察两组患者围手术期相关指标、 Cobb 角、 椎体前缘高度、 临床疗效、 脊髓神经功能恢复情况与术后并发症发生情况。 结果 联合组患者手术时间明显长于单一组、 术中出血量明显多于单一组 (t = 9.719、 51.746, P均<0.001), 而住院时间和切口愈合时间与单一组无明显差异(t = 0.265、 1.765, P= 0.792、 0.082); 术后 6 个月, 联合组患者 Cobb 角明显小于单一组、 椎体前缘高度明显高于单一组 (t = 3.345、 7.710, P= 0.001、 P<0.001); 术后 6 个月, 联合组患者临床疗效优良率为 94.29%, 明显高于单一组患者的临床疗效优良率 77.14% ( χ2 = 4.200, P = 0.040); 术后6个月, 联合组患者脊髓神经功能为C~ D 级 13 例、 E 级 22 例, 明显优于单一组患者的脊髓神经功能为 A~ B 级 1 例、 C~D 级 21 例、 E 级 13 例 (Z=-2.209, P= 0.027); 联合组患者术后并发症发生率为 8.57%, 与单一组患者的术后并发症发生率 11.43%无明显差异 (χ2 = 0.159, P= 0.690)。 结论 与经皮微创椎弓根螺钉内固定相比, 经皮微创椎弓根螺钉内固定联合后路减压植骨治疗脊柱骨折虽手术时间较长、 术中出血量较多, 但却能明显改善患者脊髓神经功能, 促进脊柱生理功能恢复, 临床应用价值更高。 |
| 英文摘要: |
| 【Abstract】 Objective To study the clinical efficacy of minimally invasive percutaneous pedicle screw fixation in combination of posterior decompression and bone grafting in the treatment of spinal fracture. Methods 70 patients with spinal fracture admitted to The Third People’s Hospital of Zhengzhou from July 2019 to July 2022 were enrolled as research subjects, and were divided into the combined group ( n = 35) and the single group ( n = 35) according to the different treating methods. Patients in the combined group were treated with minimally invasive percutaneous pedicle screw fixation in combination of posterior decompression and bone grafting, whereas patients in the single group were treated with minimally invasive percutaneous pedicle screw fixation. Perioperative indicators, Cobb angle, anterior vertebral body height, clinical efficacy, spinal cord nerve function recovery, and postoperative complications were compared between the two groups. Results The operation time of patients was significantly longer and the intraoperative blood loss was significantly more in the combined group compared with the single group ( t = 9.719 and 51.746, both P< 0.001). There were no significant differences in length of stay or wound healing time between the two groups (t = 0.265 and 1.765, P= 0.792 and 0.082). At 6 months after surgery, the Cobb angle was significantly smaller, and anterior vertebral body height was significantly higher in the combined group compared with the single group ( t = 3.345 and 7.710, P = 0.001, P<0.001). At 6 months after surgery, the clinical efficacy was significantly better in the combined group, with an excellent and good rate of 94.29%, compared to 77.14% in the single group (χ2 = 4.200, P= 0.040). At 6 months after surgery, the spinal cord nerve function of patients in the combined group was grade C-D in 13 case, grade E in 22 cases, which was obviously superior to that in the single group - grade A-B in 1 case, grade C-D in 21 cases, and grade E in 13 cases (Z= -2.209, P= 0.027). The incidence of postoperative complications was 8.57% in the combined group, showing no significant difference compared with the 11.43% in the single group ( χ2 = 0.159, P = 0.690). Conclusion Compared with minimally invasive percutaneous pedicle screw fixation, minimally invasive percutaneous pedicle screw fixation in combination of posterior decompression and bone grafting in the treatment of spinal fracture can significantly improve the spinal nerve function of the patients and promote the recovery of physiological function of the spine although the operation time is longer and the intraoperative blood loss is more, presenting high value of clinical application. |
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