经皮椎弓根螺钉短节段固定撑开复位治疗胸腰椎骨折的效果及对VAS评分的影响

荆丹峰

[关键词] 经皮椎弓根螺钉;短节段固定;撑开复位治疗;胸腰椎骨折;VAS评分

[中图分类号] R683.2          [文献标识码] B          [文章编号] 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，其占整个胸腰椎骨折发病患者的60%左右。由于机体躯干的应力活动区域较为集中在胸腰段，因此其出现骨折情况的风险较高。在临床中因车祸、高处坠落、击打损伤等因素导致的胸腰椎骨折较为常见。临床对于胸腰椎骨折患者主要采用手术治疗，手术目的在于重建患者的脊柱稳定性，对于存在脊髓神经损伤的患者，手术治疗也是一种有效修复措施[1]。有一类胸腰椎骨折患者属于AO分型，其临床特征主要为在外力的压缩作用下，椎体的高度存在一定程度的下降，但是不会出现脊髓神经损伤[2]。随着现代微创技术的发展，将该技术融入临床治疗的案列越来越普遍，在胸腰椎骨折的治疗中，经皮椎弓根螺钉内固定治疗即是具有代表性的微创技术之一，该技术具有恢复快，创伤小的优势，但是其对手术人员的操作要求较高，并且在实施该术式时需要借助较多的辅助技术[3]。本研究以该技术为探讨内容，将70例胸腰椎骨折患者为观察对象，比较常规开放式内固定治疗与经皮椎弓根螺钉短节段固定撑开复位治疗的疗效差异，现报道如下。