经皮微创与开放式椎弓根钉内固定治疗脊椎骨折的临床疗效比较

发布时间：2019-01-16 02:29

【摘要】：目的探讨经皮微创与开放式椎弓根钉内固定治疗脊椎骨折的临床疗效。方法选择脊椎骨折患者68例,根据手术方式分为经皮微创椎弓根钉内固定34例(微创组)和传统开放式手术34例(开放组)。两组性别、年龄、体质量、骨折部位及病情严重程度比较无统计学差异(P均0.05)。比较两组手术切口大小、术中出血量、手术时间及住院时间的差异,观察两组术后Cobb's角、椎体前缘高度及血清肌酸激酶活性变化。结果与开放组比较,微创组手术时间短、切口小、手术出血少、住院时间短,差异有统计学意义(P均0.05);微创组术后1、2 d血清肌酸激酶活性低于开放组(P均0.05);与治疗前比较,治疗后两组Cobb's角、椎体前缘高度均改善(P均0.01),两组治疗后Cobb's角、椎体前缘高度改善情况差异无统计学意义(P均0.05)。结论经皮微创与开放式椎弓根钉内固定治疗脊椎骨折的效果基本一致,但微创手术患者肌肉损伤程度轻,术后病情恢复快。
[Abstract]:Objective to investigate the clinical effect of percutaneous minimally invasive and open pedicle screw internal fixation in the treatment of spinal fractures. Methods Sixty-eight patients with spinal fractures were divided into two groups according to the operative methods: 34 cases of percutaneous minimally invasive pedicle screw fixation (minimally invasive group) and 34 cases of traditional open surgery (open group). There was no significant difference in sex, age, body mass, fracture site and severity between the two groups (P 0.05). The differences of incision size, blood loss, operation time and hospitalization time were compared between the two groups. The changes of Cobb's angle, anterior height of vertebral body and serum creatine kinase activity were observed. Results compared with the open group, the minimally invasive group had shorter operation time, smaller incision, less operative bleeding and shorter hospital stay (P 0.05). The activity of serum creatine kinase in the minimally invasive group was lower than that in the open group on the 2nd day after operation (P 0.05). Compared with before treatment, the Cobb's angle and the height of the anterior edge of the vertebral body were improved in the two groups after treatment (P0.01). There was no significant difference between the two groups in the improvement of the Cobb's angle and the height of the anterior edge of the vertebral body (P0. 05). Conclusion the effect of percutaneous minimally invasive treatment and open pedicle screw internal fixation for spinal fractures is basically the same, but the degree of muscle injury in patients undergoing minimally invasive surgery is light, and the recovery of postoperative condition is fast.
【作者单位】：邯郸市中心医院;
【分类号】：R687.32

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