微创经皮椎弓根螺钉术治疗脊柱骨折患者的效果及对椎间隙高度、后凸Cobb角的影响

甘华

【摘要】 目的：探討微创经皮椎弓根螺钉术（PPS）治疗脊柱骨折患者的效果及对椎间隙高度、后凸Cobb角的影响。方法：选取2019年3月-2020年3月本院确诊并治疗的68例脊柱骨折患者，根据手术治疗方式分为对照组和研究组，每组34例。对照组应用开放内固定术，研究组应用微创PPS术。比较两组术中出血量、手术时间、住院时间、不良反应发生情况，比较两组治疗前及治疗后3、6个月的椎间隙高度和后凸Cobb角。结果：研究组术中出血量少于对照组，手术时间和住院时间均短于对照组，差异均有统计学意义（P<0.05）。治疗前，两组椎间隙高度、后凸Cobb角比较，差异均无统计学意义（P>0.05）;治疗后3、6个月，两组椎间隙高度均高于治疗前，后凸Cobb角均低于治疗前，差异均有统计学意义（P<0.05）。治疗后3、6个月，两组椎间隙高度、后凸Cobb角比较，差异均无统计学意义（P>0.05）。研究组并发症发生率低于对照组，差异有统计学意义（P<0.05）。结论：给予脊柱骨折患者使用微创PPS术治疗，手术时间短、出血量少、可缩短患者的住院时间，且与开放内固定术相比，患者椎间隙高度水平、后凸Cobb角水平恢复情况无差异。

【关键词】 脊柱骨折 经皮椎弓根螺钉术 后凸Cobb角 椎间隙高度

The Effect of Minimally Invasive Percutaneous Pedicle Screw Surgery in the Treatment of Patients with Spinal Fractures and Its Influence on Intervertebral Space Height and Kyphosis Cobb Angle/GAN Hua. //Medical Innovation of China， 2021， 18（27）： 0-064

[Abstract] Objective： To investigate the effect of minimally invasive percutaneous pedicle screw surgery （PPS） in the treatment of patients with spinal fracture and its influence on intervertebral space height and kyphosis Cobb angle. Method： A total of 68 patients with spinal fracture diagnosed and treated in our hospital from March 2019 to March 2020 were selected， they were divided into control group and study group according to surgical treatment methods， 34 cases in each group. The control group was treated with open internal fixation and the study group was treated with minimally invasive PPS. The amount of intraoperative blood loss， surgical time， length of hospital stay and the occurrence of adverse reactions were compared between two groups， the intervertebral space height and kyphosis Cobb angle before treatment and 3 and 6 months after treatment were compared between two groups. Result： The amount of intraoperative blood loss in the study group was less than that in the control group， and the surgical time and length of hospital stay were shorter than those in the control group， the differences were statistically significant （P<0.05）. Before treatment， there were no significant differences in intervertebral space height and kyphosis Cobb angle between two groups （P>0.05）; 3 and 6 months after treatment， the intervertebral space height in both groups were higher than those before treatment， and the kyphosis Cobb angle in both groups were lower than those before treatment treatment， the differences were statistically significant （P<0.05）. 3 and 6 months after treatment， there were no significant differences in intervertebral space height and kyphosis Cobb angle between two groups （P>0.05）. The complication rate in the study group was lower than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： The minimally invasive PPS for patients with spinal fracture has shorter surgical time， less blood loss and shorter length of hospital stay. Compared with the open internal fixation， there are no differences in the recovery of intervertebral space height and kyphosis Cobb angle.

[Key words] Spinal fracture Percutaneous pedicle screw surgery Kyphosis Cobb angle Intervertebral space height

First-author’s address： Xiangzhou District People’s Hospital， Xiangyang 441000， China

doi：10.3969/j.issn.1674-4985.2021.27.016

骨科临床中较为常见的一种疾病类型就是脊柱骨折，好发于胸腰段[1]。导致脊柱骨折发生的原因主要为间接性外力，在临床中的症状表现则主要包括脊柱畸形、疼痛等，情况严重的甚至会出现脊髓损伤[2]。通常需要给予患者影像学方面的检查以确诊，在给予患者实施相关保守治疗，如固定、牵引及复位等，同时还要给予患者手术治疗以确保康复效果[3]。……