經皮椎弓根螺釘短節段固定撐開復位治療胸腰椎骨折的效果及對VAS評分的影響

荊丹峰

[關鍵詞] 經皮椎弓根螺釘;短節段固定;撐開復位治療;胸腰椎骨折;VAS評分

[中圖分類號] R683.2? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）20-0085-04

Effect of percutaneous pedicle screw short-segment fixation and distraction reduction in treatment of thoracolumbar fractures and its influence on VAS score

JING Danfeng

Department of Orthopedics， Jintan Hospital Affiliated to Jiangsu University，First People′s Hospital of Jintan District of Changzhou City， Changzhou? ?213200， China

[Abstract] Objective To explore the effect of percutaneous pedicle screw short-segment fixation and distraction reduction in the treatment of thoracolumbar fractures and its influence on the VAS score. Methods Seventy patients diagnosed with thoracolumbar fractures admitted to our hospital from February 2016 to May 2020 were selected. They were divided into two groups according to the order of admission time， as the control group （the first 35 patients admitted to the hospital） and the observation group （the latter 35 patients admitted to the hospital）.The control group were treated with conventional open internal fixation， and the observation group were treated with percutaneous pedicle screw short-segment fixation and distraction reduction. The differences in operation time， intraoperative blood loss， total hospital stay， Cobb angle of injured vertebral kyphosis， and VAS pain score were compared between the two groups. Results The operation time （103.47±28.01） min，intraoperative blood loss （118.32±30.22） mL and total hospital stay （10.72±2.33） d of the observation group were lower than those of the control group， which were （118.32±30.22） min， （354.65±115.49） mL and （18.64±5.79）d， with statistically significant differences（P<0.05）. There were no statistically significant differences in the Cobb angle of injured vertebral kyphosis and VAS pain score before operation and at 1 day and 6 months after operation between the two groups（P>0.05）. Conclusion Percutaneous pedicle screw short-segment fixation and distraction reduction has a significant effect in the treatment of thoracolumbar fractures， with less trauma and quicker recovery after surgery. It has clinical application value.

[Key words] Percutaneous pedicle screw; Short-segment fixation; Distraction reduction treatment; Thoracolumbar fractures; VAS score

在脊柱骨折中，常見分型有胸腰椎骨折，其占整個胸腰椎骨折發病患者的60%左右。由于機體軀干的應力活動區域較為集中在胸腰段，因此其出現骨折情況的風險較高。在臨床中因車禍、高處墜落、擊打損傷等因素導致的胸腰椎骨折較為常見。臨床對于胸腰椎骨折患者主要采用手術治療，手術目的在于重建患者的脊柱穩定性，對于存在脊髓神經損傷的患者，手術治療也是一種有效修復措施[1]。有一類胸腰椎骨折患者屬于AO分型，其臨床特征主要為在外力的壓縮作用下，椎體的高度存在一定程度的下降，但是不會出現脊髓神經損傷[2]。隨著現代微創技術的發展，將該技術融入臨床治療的案列越來越普遍，在胸腰椎骨折的治療中，經皮椎弓根螺釘內固定治療即是具有代表性的微創技術之一，該技術具有恢復快，創傷小的優勢，但是其對手術人員的操作要求較高，并且在實施該術式時需要借助較多的輔助技術[3]。本研究以該技術為探討內容，將70例胸腰椎骨折患者為觀察對象，比較常規開放式內固定治療與經皮椎弓根螺釘短節段固定撐開復位治療的療效差異，現報道如下。