经皮椎弓根钉内固定结合自固化磷酸钙伤椎强化治疗胸腰椎骨折的临床疗效

doi:10.3969/j.issn.1006-6233.2022.06.017

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摘要 目的: 分析应用经皮椎弓根钉内固定结合微创自固化磷酸钙伤椎强化治疗胸腰椎骨折的临床的效果。方法: 回顾性分析2019年6月至2020年6月承德市中心医院收治的61例胸腰椎骨折患者,其中31例采用经皮椎弓根内固定术治疗(单纯内固定组);30例采用经皮椎弓根钉内固定结合微创自固化磷酸钙伤椎强化治疗(内固定强化组)。所有患者随访13~25个月,平均(15.95±0.76)个月,比较两组患者围手术期、随访和影像资料。结果: 单纯固定组的手术时间小于内固定强化组(P<0.05)。两组患者在两组的切口长度、术中出血量及住院时间之间的差异均无统计学意义(P>0.05),两组内固定物失效的发生率之间的差异无统计学意义(P>0.05),两组患者术后VAS评分、ODI评分之间的差异无统计学意义(P>0.05),末次随访时内固定强化组的VAS评分、ODI评分均优于单纯内固定组(P<0.05)。影像方面,两组术后伤椎前缘压缩比、矢状位Cobb角之间的差异无统计学意义(P>0.05),末次随访时内固定强化组的伤椎前缘丢失量、Cobb角丢失量均小于单纯内固定组(P<0.05)。结论: 经皮椎弓根钉内固定结合微创自固化磷酸钙伤椎强化治疗胸腰椎体骨折,可以减少后期伤椎前缘高度的丢失量,减少术后残余腰痛,有利于腰椎功能的恢复。

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关键词 ：微创, 内固定, 骨水泥, 胸腰椎体骨折

Abstract：Objective: To evaluate the clinical efficacy of percutaneous pedicle screw fixation combined with self-curing calcium phosphate in intensive treatment of thoracolumbar vertebral fracture. Methods: A total of 61 patients with thoracolumbar fracture admitted between June 2019 and June 2020 were enrolled in this study. Thirty-one patients were treated with percutaneous pedicle screw fixation(simple internal fixation group), thirty patients were treated with percutaneous pedicle screw fixation combined with minimally invasive self-curing calcium phosphate for intensive treatment (internal fixation and strengthening group). All patients were followed up for 13～25 months, with an average of (15.95±0.76) months. Perioperative indicators, follow-up indicators and imaging data were compared between the two groups. Results: The operation time of simple fixation group was less than that of the internal fixation and strengthening group (P<0.05). There were no statistical significance between the two groups in incision length, intraoperative blood loss and length of hospital stay (P>0.05). There was no statistical significance in the incidence of internal fixation failure between the two groups (P>0.05). There was no statistical significance in postoperative VAS score and ODI score between the two groups (P>0.05). At the last follow-up, the VAS score and ODI score of the simple fixation group were higher than those in the internal fixation and strengthening group (P<0.05). In terms of imaging, there was no statistical significance in compression ratio of the anterior edge of the injured vertebra and sagittal Cobb Angle between the two groups (P>0.05). At the last follow-up, the compression ratio of the anterior edge of the injured vertebra loss and Cobb Angle loss in the simple fixation group were greater than those in the internal fixation and strengthening group (P<0.05). Conclusion: Percutaneous pedicle screw fixation combined with minimally invasive self-curing calcium phosphate for intensive treatment can reduce the incidence of late vertebral height loss, reduce postoperative residual lumbago, so that patients can get better function.

Key words： Minimally invasive Internal fixation Bone cement Thoracolumbar fracture

基金资助:河北省承德市科技计划项目,(编号:202102A012)

通讯作者: 孙彦豹

引用本文:

王静, 刘佳骥, 孙彦豹, 金宝城, 徐文硕, 白冰. 经皮椎弓根钉内固定结合自固化磷酸钙伤椎强化治疗胸腰椎骨折的临床疗效[J]. 河北医学, 2022, 28(6): 955-959.
WANG Jing, LIU Jiaji, SUN Yanbao, et al. Clinical Efficacy of Percutaneous Pedicle Screw Fixation Combined with Self-Curing Calcium Phosphate in Intensive Treatment of Thoracolumbar Vertebral Fracture. HeBei Med, 2022, 28(6): 955-959.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2022.06.017 或 http://www.hbyxzzs.cn/CN/Y2022/V28/I6/955