| 李增超,时群峰.单侧椎弓根螺钉内固定联合经椎间孔椎间融合治疗骨质疏松性胸腰椎骨折疗效分析[J].中国烧伤创疡杂志,2024,(1):28~32. |
| DOI： |
| 中文关键词: 经椎间孔椎间融合 椎弓根螺钉内固定 骨质疏松 椎体骨折 椎体功能 |
| 英文关键词:Transforaminal lumbar interbody fusion Pedicle screw fixation Osteoporosis Vertebral fracture Vertebral function |
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| 中文摘要: |
| 【摘要】 目的 探讨单侧椎弓根螺钉内固定联合经椎间孔椎间融合治疗骨质疏松性胸腰椎骨折的临床疗效。方法 选取 2020 年 1 月至 2022 年 1 月驻马店魏道德骨科医院收治的 96 例骨质疏松性胸腰椎骨折患者作为研究对象, 按照不同治疗方法将其分为研究组 (45 例) 与常规组 (51 例), 研究组患者采用单侧椎弓根螺钉内固定联合经椎间孔椎间融合治疗, 常规组患者单纯采用单侧椎弓根螺钉内固定治疗, 对比观察两组患者手术相关指标、椎体解剖结构及功能、疼痛程度、并发症发生情况与再骨折情况。 结果 研究组患者术中出血量明显多于常规组 (t = 39.581, P<0.001), 术后下床活动时间、住院时间均明显长于常规组 ( t = 36.312、19.972, P均<0.001); 术后 12个月, 研究组患者伤椎椎体前缘高度明显高于常规组 ( t = 4.914, P< 0.001), 椎体压缩率、Cobb 角、受压面积均明显小于常规组 (t = 8.922、16.056、8.483, P 均<0.001), Oswestry 功能障碍指数 (ODI)评分及视觉模拟评分法 (VAS) 评分均明显低于常规组 ( t = 10.633、12.680, P 均<0.001); 术后随访 12 个月,研究组患者术后并发症发生率为 2.22%, 与常规组患者的术后并发症发生率 9.80%无明显差异 (χ2 = 2.345, P =0.126), 而再骨折率为 0%, 明显低于常规组患者的再骨折率 11.76% (χ2 = 5.647, P = 0.017)。 结论 单侧椎弓根螺钉内固定联合经椎间孔椎间融合治疗骨质疏松性胸腰椎骨折, 虽可延长术后下床活动时间及住院时间, 但能有效恢复伤椎椎体解剖结构, 提高椎体功能, 减轻患者疼痛, 降低再骨折率, 疗效显著, 值得临床推广应用。 |
| 英文摘要: |
| 【Abstract】 Objective To study the clinical efficacy of unilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion in treating osteoporotic thoracolumbar vertebral fractures. Methods 96 patients with osteoporotic thoracolumbar vertebral fractures, admitted to Zhumadian Weidaode Orthopedics Hospital between January 2020 andJanuary 2022, were enrolled as research subjects, and divided into study group (n = 45) and control group (n = 51) based on the treatments they received. Patients in the study group received a combined treatment of unilateral pedicle screw fixation and transforaminal lumbar interbody fusion, whereas patients in the control group underwent unilateral pedicle screw fixationalone. Analyses were conducted to compare the following factors, surgery-related indicators, anatomic structures and functions of the vertebral body, pain intensity, complication rate, and re-fracture rate between the two groups. Results Intraoperative blood loss in the study group was markedly more than that in the control group ( t = 39.581, P< 0.001). Additionally, postoperative ambulation time and length of stay were significantly longer in the study group ( t = 36.312 and 19.972, both P<0.001). 12 months after surgery, patients had higher anterior vertebral body height in the study group than the control group (t = 4.914, P<0.001), but lower vertebral compression ratio and Cobb angle and smaller compressed area as opposed to the control group (t = 8.922, 16.056 and 8.483, all P<0.001), and both Oswestry disability index (ODI) score and visual analogue scale (VAS) score were significantly lower in the study group (t = 10.633 and 12.680, both P< 0.001). During the 12-month follow-up after surgery, the complication rate of patients in the study group was 2.22%, which showed no significant difference compared with the corresponding 9.80% in the control group ( χ2 = 2.345, P =0.126). However, the re-fracture rate of patients was 0% in the study group, being significantly lower than the corresponding 11.76% in the control group ( χ2 = 5.647, P = 0.017). Conclusion Unilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion in the treatment of osteoporotic thoracolumbar fractures, though may lead to longer postoperative ambulation time and length of stay, can effectively restore the anatomic structures of the injured vertebra and enhance its function, alleviate patients’ pain and significantly reduce the re-fracture rate, deserving to be promoted in clinical practice given its definite therapeutic effects. |
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