后路经椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折临床研究

左明相

【摘要】 目的：研究后路經椎弓根内固定结合椎体成形术治疗老年胸腰段脊柱骨折的临床效果。方法：选择2018年12月-2019年10月入院接受治疗的68例老年胸腰段脊柱骨折患者，按照抽签法将其分为对照组和研究组，各34例。对照组给予短节段椎弓根钉内固定手术治疗，研究组给予后路经椎弓根内固定结合椎体成形术治疗，比较两组临床效果。结果：术前，两组脊柱后凸Cobbs角、椎体前缘高度压缩率、椎体后缘高度压缩率比较，差异均无统计学意义（P>0.05）;术后，研究组脊柱后凸Cobbs角（4.2±0.6）°、椎体前缘高度压缩率（7.3±2.2）%、椎体后缘高度压缩率（1.7±0.2）%，均低于对照组的（4.9±1.9）°、（16.7±7.7）%、（3.8±1.9）%，差异均有统计学意义（P<0.05）。术后对两组患者均随访3个月，研究组不良反应发生率明显优于对照组，差异有统计学意义（P<0.05）。结论：老年胸腰段脊柱骨折的临床治疗中应用后路经椎弓根内固定结合椎体成形术临床效果显著，可为预后治疗奠定基础，可应用于临床上。

【关键词】 后路经椎弓根内固定结合椎体成形术 老年胸腰段脊柱骨折 临床效果

doi：10.14033/j.cnki.cfmr.2020.13.053 文献标识码 B 文章编号 1674-6805（2020）13-0-03

Clinical Study of Posterior Pedicle Internal Fixation Combined with Vertebroplasty in the Treatment of Thoracolumbar Spinal Fractures in the Elderly/ZUO Mingxiang. //Chinese and Foreign Medical Research， 2020， 18（13）： -131

[Abstract] Objective： To study the clinical effect of posterior pedicle internal fixation combined with vertebroplasty in the treatment of thoracolumbar spine fractures in the elderly. Method： Sixty-eight elderly patients with thoracolumbar spine fractures admitted in our hospital from December 2018 to October 2019 were selected and divided into the control group and the study group according to the method of lottery， with 34 cases each group. The control group was treated with short-segment pedicle screw internal fixation. The study group was treated with posterior pedicle internal fixation combined with vertebroplasty. The clinical effects of the two groups were compared. Result： Before operation， there were no significant differences in the kyphosis Cobbs angle， the compression rate of anterior edge height of vertebral body and the compression rate of posterior edge height of vertebral body between the two groups （P>0.05）. After operation， the kyphosis Cobbs angle （4.2±0.6）°， the compression rate of anterior edge height of vertebral body （7.3±2.2）%， and the compression rate of posterior edge height of vertebral body （1.7±0.2）% in the study group were all lower than （4.9±1.9）°， （16.7±7.7）% and （3.8±1.9）%， in the control group， the differences were statistically significant （P<0.05）. The two groups were followed up for 3 months after operation， and the incidence of adverse reactions in the study group was significantly higher than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： The clinical application of posterior pedicle internal fixation combined with vertebroplasty in the clinical treatment of thoracolumbar spine fractures in the elderly has a significant clinical effect， which can lay the foundation for treatment of prognosis， it can be applied in clinic.

[Key words] Posterior pedicle internal fixation combined with vertebroplasty Thoracolumbar spine fractures in the elderly Clinical effect

First-authors address： The First Peoples Hospital of Wanzhou District in Chongqing， Chongqing 404100， China

胸腰椎骨折是脊柱骨折的易发部位，其致残率和死亡率较高。老年人由于各器官功能逐渐衰退、骨质疏松等生理特点，更容易发生胸腰椎骨折[1]。主要临床症状为局部疼痛、站立翻身困难、腹胀、腹痛等。一旦骨折发生，脊柱的稳定性就会受到破坏，导致脊柱不稳，背部剧痛。如果再加上椎管狭窄，极易引起下肢神经症状，严重影响患者的生活质量，对其健康造成极大危害[2]。因此，需要及时治疗。传统的保守治疗虽然可以缓解患者的临床症状，但恢复时间相对较长，患者需要长时间卧床，容易引起静脉血栓形成、肺部感染、褥疮形成甚至肺栓塞等并发症，影响临床疗效[3]。目前，后路经椎弓根内固定结合椎体成形术已被广泛应用于临床。基于……