摘要
目的探讨在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗伴有神经根损伤的胸腰椎骨折疗效。方法选取2019年6月至2020年6月于本院就诊的胸腰椎骨折伴神经根损伤患者60例,按照单双日分成A组与B组,每组各30例。A组予以传统开放椎弓根螺钉复位内固定治疗,B组在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗。并比较治疗前后伤椎Cobb角,伤椎椎体前缘高度比值变化,术后疼痛程度及相关手术指标。结果术后两组患者各时间节点伤椎Cobb角,伤椎椎体前缘高度比值比较,差异无统计学意义(P>0.05)。术后24 h疼痛程度评分比较,A组高于B组,差异有统计学意义(P<0.05)。A组手术时间、术中出血、切口长度及术后引流量为(147.61±10.36)min,(344.46±40.56)mL,(12.34±1.79)cm,(224.10±9.89)mL;B组分别为(121.23±7.78)min,(91.28±5.98)mL,(7.71±1.28)cm,(54.56±6.78)mL;B组均低于A组,差异有统计学意义(P<0.05)。结论对胸腰椎骨折伴神经根损伤患者在微创通道下减压结合经皮椎弓根螺钉复位内固定治疗,可取得与传统开放手术相同的疗效,但其创伤性更低,安全性更高,有助于减轻患者术后疼痛,并加快患者康复,具有推广应用价值。
Objective To explore the therapeutic effect of minimally invasive decompression combined with percutaneous pedicle screw reduction and internal fixation on thoracolumbar fractures with nerve root injury.Methods A total of 60 patients with thoracolumbar fracture and nerve root injury in our hospital from June 2019 to June 2020 were divided into group A and group B,with 30 cases in each group.Group A was treated with traditional open pedicle screw reduction and internal fixation,while group B was treated with minimally invasive channel decompression combined with percutaneous pedicle screw reduction and internal fixation.The Cobb angle of the injured vertebra,the changes of the ratio of the anterior height of the injured vertebral body,the degree of postoperative pain and related surgical indexes before and after treatment were compared.Results The Cobb angle of the injured vertebra and the ratio of the anterior edge height of the injured vertebral body in the two groups had no comparative value at each time node after operation(P>0.05).The pain degree score was higher in group A than that of group B on the 24 h after operation,and the comparison was statistically significant(P<0.05).The operation time,intraoperative bleeding,incision length and postoperative drainage volume were(147.61±10.36)min,(344.46±40.56)mL,(12.34±1.79)cm and(224.10±9.89)mL in group A,respectively,and(121.23±7.78)min,(91.28±5.98)mL,(7.71±1.28)cm,(54.56±6.78)mL in group B,respectively Group B WCLS lower than Group A,the differences between the two groups were statistically significant(P<0.05).Conclusion Minimally invasive decompression combined with percutaneous pedicle screw reduction and internal fixation can achieve the same curative effect as traditional open surgery for thoracolumbar fractures with nerve root injury,with less trauma and higher safety.It is helpful to relieve postoperative pain and accelerate recovery of patients,with popularization and application value.
作者
熊怀风
丁超
梁甜
王敏
刘庆波
李传望
詹义兵
XIONG Huaifeng;DING Chao;LIANG Tian;WANG Min;LIU Qingbo;LI Chuanwang;ZHAN Yibing(The Second Department of Osteology,Jingzhou Third People′s Hospital in Hubei Province,Jingzhou434000,China)
出处
《中国现代医生》
2021年第14期92-94,98,共4页
China Modern Doctor
关键词
微创通道
减压
经皮椎弓根螺钉复位内固定
神经根损伤
胸腰椎骨折
疼痛度
Minimally invasive channel
Decompression
Percutaneous pedicle screw reduction and internal fixation
Nerve root injury
Thoracolumbar fracture
Degree of pain
