摘要
目的探讨微创伤椎植骨、伤椎置钉联合经皮椎弓根螺钉内固定治疗无神经损伤型胸腰椎爆裂骨折的临床效果。方法选取2016年6月至2018年5月本院收治的无神经损伤型胸腰椎爆裂骨折患者75例作为研究对象,随机数字表法分为A组、B组、C组,各25例。A组单纯伤椎临近节段经皮椎弓根钉内固定治疗;B组伤椎植骨联合临近节段经皮椎弓根钉内固定治疗;C组伤椎置钉联合临近节段经皮椎弓根钉内固定治疗。比较3组神经功能ASIA分级、手术时间、术中失血量,术前、术后2周及2年疼痛视觉模拟(VAS)评分、日本矫正外科协会(JOA)评分、Cobb角。结果术前,3组神经功能ASIA分级差异无统计学意义(P>0.05);术后,B组神经功能ASIA分级改善程度优于C组,C组改善程度优于A组,差异具有统计学意义(均P<0.05)。B组手术时间和术中出血量[(88.58±3.91)min、(94.87±19.29)ml]高于C组[(73.32±4.34)min、(76.62±15.31)ml],C组大于A组[(64.89±3.26)min、(65.62±14.52)ml],差异具有统计学意义(均P<0.05)。术前,3组VAS评分、JOA评分、Cobb角差异无统计学意义(均P>0.05);术后2周及2年,B组JOA评分均高于C组,C组均高于A组,B组VAS评分和Cobb角均低于C组,C组均低于A组,差异具有统计学意义(均P<0.05)。结论伤椎植骨联合临近节段经皮椎弓根钉内固定治疗无神经损伤型胸腰椎爆裂骨折的临床效果较好,可明显改善患者神经功能,明显减轻患者的疼痛程度,矫正脊柱后凸的畸形,远期矫正丢失较少,但术中出血量较多。
Objective To explore the clinical effect of minimally invasive vertebral bone grafting,wounded vertebral nail placement,and percutaneous pedicle screw internal fixation for thoracolumbar burst fractures without nerve injury.Methods From June,2016 to May,2018,75 patients with thoracolumbar burst fractures and no nerve injury treated at our hospital from June,2016 to May,2018 were selected as the research objects,and were randomly divided into group A,group B,and group C,with 25 cases in each group.Group A were treated with percutaneous pedicle screw fixation for the adjacent segment of the injured vertebrae;in addition,group B were treated with minimally invasive vertebral bone grafting,and group C with wounded vertebral nail placement.The neurological function ASIA grades,operation times,intraoperative blood loss,and visual analogue(VAS)scores of pain,Japan Orthopedics Association(JOA)scores,and Cobb angles before and 2 weeks and 2 years after operation were compared between the three groups.Results There was no statistical difference in the ASIA grading of neurological function between the three groups before operation(P>0.05);the ASIA grading of neurological function in group B was better than that in group C,and that group C was better than that of group A after operation(P<0.05).The operation times and intraoperative blood loss were in(88.58±3.91)min and(94.87±19.29)ml in group B,were(73.32±4.34)min and(76.62±15.31)ml in group C,and were(64.89±3.26)min and(65.62±14.52)ml in group A,with statistical differences(all P<0.05).There were no statistical differences in VAS and JOA scores and Cobb angle between the three groups before operation(all P>0.05).Two weeks and two years after operation,the JOA scores in group B were higher than those in group C,and those in group C were higher than those in group A;the VAS scores and Cobb angles of group B were lower than those of group C,and those of group C was lower than those of group A,with statistical differences(all P<0.05).Conclusion Injury vertebral bone graf
作者
唐灿锐
张允烨
黄东博
李世渊
谭建基
Tang Canrui;Zhang Yunye;Huang Dongbo;Li Shiyuan;Tan Jianji(Department of Orthopedics,Luoding People's Hospital,Luoding 527200,China)
出处
《国际医药卫生导报》
2021年第5期679-682,共4页
International Medicine and Health Guidance News
基金
云浮市科技计划项目(WS201840)。
关键词
无神经损伤型
胸腰椎爆裂骨折
微创伤椎植骨
伤椎置钉
经皮椎弓根螺钉内固定
临床疗效
No nerve injury type
Thoracolumbar vertebral burst fractures
Minimally invasive vertebral bone grafting
Wounded vertebral nail placement
Percutaneous pedicle screw internal fixation
Clinical efficacy
