【摘要】 目的:探讨经皮椎弓根螺钉微创手术治疗胸腰椎骨折的临床效果。方法:将2017年1月-2019年1月在笔者所在医院骨科治疗的94例无神经损伤胸腰椎骨折患者随机分为两组,对照组47例行传统开放性椎弓根螺钉固定术,观察组47例行经皮椎弓根螺钉微创手术,对比两组各项手术指标、手术前后椎体前缘高度比及后凸Cobb角、VAS评分、并发症发生率。结果:观察组手术时间、切口长度、术中出血量、术后下床活动时间、住院时间均优于对照组(P<0.05);观察组术后1周及术后6个月椎体前缘高度比、后凸Cobb角与对照组比较,差异均无统计学意义(P>0.05);观察组术后1周及术后6个月VAS评分均明显低于对照组(P<0.05);观察组固定物松动、神经根损伤、切口感染发生率低于对照组(P<0.05)。结论:经皮椎弓根螺钉微创手术治疗胸腰椎骨折的临床效果显著,创伤小,术后疼痛轻,并发症发生率低,对伤椎生理高度和弧度的恢复效果好,且患者术后恢复更快,具有积极的临床意义。更多还原

【Abstract】 Objective:To investigate the clinical effect of minimally invasive operation of percutaneous pedicle screw on thoracolumbar fracture.Method:The 94 patients with thoracolumbar fractures without nerve injury treated in the orthopedics department of our hospital from January 2017 to January 2019 were randomly divided into two groups.In the control group,47 patients underwent traditional open pedicle screw fixation.In the observation group,47 patients underwent minimally invasive operation of percutaneous pedicle screw.The operative indexes,ratio of anterior vertebral body height and posterior Cobb angle before and after the operation,VAS scores and incidence of complications were compared between the two groups.Result:The time of operation,length of incision,amount of bleeding during operation,time of getting out of bed after operation and time of hospitalization in the observation group were better than those of the control group (P<0.05).The ratio of anterior vertebral body height and posterior Cobb angle in the observation group at 1 week and 6 months after operation were compared with those of the control group,and the differences were not statistically significant (P>0.05).The VAS scores at 1 week and 6 months after operation in the observation group were significantly lower than those of the control group (P<0.05).The incidence of fixation loosening,nerve root injury and incision infection in the observation group was lower than that of the control group (P<0.05).Conclusion:The clinical effect of minimally invasive operation of percutaneous pedicle screw in the treatment of thoracolumbar fractures is remarkable,the trauma is small,the postoperative pain is light,the incidence of complications is low,and the recovery effect of physiological height and radians of the injured vertebrae is good,and the postoperative recovery is faster,which has positive clinical significance.更多还原