摘要
目的比较无神经症状胸腰椎骨折患者采用经皮椎弓根螺钉复位内固定术与Wiltse入路复位内固定术治疗的临床效果。方法抽取2021年2月至2022年10月许昌市中心医院收治的无神经症状胸腰椎骨折患者74例,采用随机数字表法分为对照组和研究组,每组37例。对照组采用经皮椎弓根螺钉复位内固定术,研究组采用Wiltse入路复位内固定术,比较两组围术期指标(手术时间、术中出血量、下床时间和住院时间)及并发症发生情况。比较两组手术前后疼痛评分、Oswestry功能障碍指数(ODI)及伤椎Cobb角、前缘高度比。结果研究组手术时间、下床活动时间短于对照组,术中出血量大于对照组,住院时间长于对照组(P<0.05)。术后1周,研究组疼痛评分、ODI均低于对照组(P均<0.05)。术后1周,研究组伤椎前缘高度比低于对照组,Cobb角小于对照组(P<0.05)。研究组术后并发症发生率(5.41%,2/37)与对照组(16.22%,6/37)比较差异未见统计学意义(P>0.05)。结论经皮椎弓根螺钉与Wiltse入路复位内固定术治疗无神经症状胸腰椎骨折患者均安全有效,但Wiltse入路复位内固定术手术时间短,术后伤椎Cobb角、前缘高度比较低,临床疗效更佳。
Objective To compare the effect of percutaneous pedicle screw internal fixation and internal fixation via Wiltse approach on thoracolumbar fractures without neurological symptoms.Methods A total of 74 patients with thoracolumbar fractures without neurological symptoms admitted to Xuchang Central Hospital from February 2021 to October 2022 were selected,and they were divided into control group and study group by random number table method,with 37 patients in each group.The control group was treated by percutaneous pedicle screw reduction and internal fixation,while the study group underwent reduction and internal fixation via Wiltse approach.The perioperative indexes(operation time,intraoperative blood loss,time of out-of-bed,hospital stay)and incidence of adverse reactions were compared between the two groups.The pain score,Oswestry disability index(ODI),Cobb angle of injured vertebrae,anterior vertebral height ratio of the two groups were compared before and after treatment.Results The operation time and time of out-of-bed activity in the study group were shorter than those in the control group,while intraoperative blood loss and hospital stay were longer than those in the control group(P<0.05).The pain score and ODI in the study group were lower than those in the control group 1 week after surgery(all P<0.05).One week after surgery,the anterior vertebral height ratio in the study group was lower than that in the control group,and the Cobb angle was smaller than that in the control group(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the study group(5.41%,2/37)and the control group(16.22%,6/37),P>0.05.Conclusions Both percutaneous pedicle screw internal fixation and internal fixation via Wiltse approach are safe and effective in the treatment of thoracolumbar fractures without neurological symptoms.However,internal fixation via Wiltse approach has a shorter operation time,smaller Cobb angle,lower anterior vertebral height ratio after operation,an
作者
岳晓香
王一公
菅炎鹏
徐松山
Yue Xiaoxiang;Wang Yigong;Jian Yanpeng;Xu Songshan(Department of Surgery,Xuchang Central Hospital,Xuchang 461000,China;Department of Spine and Spinal Cord Surgery,Xuchang Central Hospital,Xuchang 461000,China)
出处
《中国实用医刊》
2023年第15期15-18,共4页
Chinese Journal of Practical Medicine
关键词
胸腰椎骨折
经皮椎弓根螺钉内固定术
Wiltse入路复位内固定术
临床疗效
Thoracic and lumbar spine fracture
Percutaneous pedicle screw internal fixation
Internal fixation via Wiltse approach
Clinical efficacy
