摘要
目的:对比分析经皮椎弓根钉固定与后正中肌间隙入路椎弓根钉固定治疗胸腰椎骨折的临床效果,为今后临床治疗选择治疗方案提供有利的参考依据。方法:选取2021年3月—2024年1月北京王府中西医结合医院收治的76例胸腰椎骨折患者,按照固定方式分为经皮组40例与后正中肌间隙入路组36例。经皮组采取经皮椎弓根钉固定治疗,后正中肌间隙入路组采取后正中肌间隙入路椎弓根定固定治疗,比较两组临床效果。结果:经皮组手术时间长于后正中肌间隙入路组,住院时间短于后正中肌间隙入路组,且术中出血量少于后正中肌间隙入路组,差异有统计学意义(P<0.05)。术后1个月,两组视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)评分低于术前,且经皮组低于后正中肌间隙入路组,差异有统计学意义(P<0.05)。术后1个月,两组科布氏(Cobb)角小于术前,差异有统计学意义(P<0.05)。经皮组术后并发症发生率为2.50%,与后正中肌间隙入路组的5.56%比较,差异无统计学意义(P>0.05)。结论:经皮椎弓根钉固定治疗胸腰椎骨折的临床效果显著,术中出血量更少,缩短住院时间,同时术后恢复更快,与后正中肌间隙入路椎弓根钉固定治疗胸腰椎骨折相比,两者安全性均较佳,但手术时间更长,术后1个月疼痛程度更轻,生活能力及行动能力更强。
Objective:To compare and analyze the clinical effects of percutaneous pedicle nail fixation and posterior median intermuscular space approach pedicle fixation in the treatment of thoracolumbar fractures,and to provide a favorable reference for future clinical treatment options.Method:A total of 76 patients with thoracolumbar fractures who admitted to Beijing Royal Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to January 2024 were selected,and they were divided into percutaneous group 40 cases and posterior median intermuscular approach group 36 cases according to the fixation method.The percutaneous group was treated with percutaneous pedicle nail fixation,and the posterior median intermuscular approach group was treated with posterior median intermuscular space approach pedicle fixation.The clinical effects of two groups were compared.Result:The operation time of the percutaneous group was longer than that of the posterior median intermuscular approach group,the hospitalization time was shorter than that of the posterior median intermuscular approach group,and the intraoperative blood loss was less than that of the posterior median intermuscular approach group,the differences were statistically significant(P<0.05).At 1 month after operation,the scores of visual analogue scale(VAS)and Oswestry dysfunction index(ODI)in two groups were lower than those before operation,and those in the percutaneous group were lower than those in the posterior median intermuscular approach group,the differences were statistically significant(P<0.05).At 1 month after operation,the Cobb angle of two groups were smaller than those before operation,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the percutaneous group was 2.50%,compared with 5.56%in the posterior median intermuscular approach group,the difference was not statistically significant(P>0.05).Conclusion:The clinical effect of percutaneous pedicle nail fixation in the treatment of thoracolumbar fractures is significant,the intraoperative blood loss is less,the hospitalization time is shortened,and the postoperative recovery is faster.Compared with the posterior median intermuscular space approach pedicle fixation for the treatment of thoracolumbar fractures,the safety of both are better,but the operation time is longer,the pain degree is lighter at 1 month after operation,and the living ability and action ability are stronger.
作者
韩建华
齐永建
郭永生
郑圣安
HAN Jianhua;QI Yongjian;GUO Yongsheng;ZHENG Sheng'an(Beijing Royal Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 102200,China;不详)
出处
《中外医学研究》
2025年第16期9-13,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
经皮椎弓根钉固定
后正中肌间隙入路椎弓根钉固定
胸腰椎骨折
视觉模拟评分法
COBB角
Percutaneous pedicle nail fixation
Posterior median intermuscular space approach pedicle fixation
Thoracolumbar fracture
Visual analogue scale
Cobb angle
