新型脊柱外固定器联合微创技术治疗胸腰椎脊柱骨折的临床探讨

摘要

目的：探讨胸腰椎脊柱骨折行新型脊柱外固定器联合微创技术治疗的临床效果。方法：选取2012年1月-2016年1月本院收治的300例胸腰椎脊柱骨折患者作为此次研究对象，按随机数字表法将其分为对照组和观察组，每组150例，对照组行微创小切口肌间隙入路椎弓根内固定术，观察组行新型脊柱外固定器联合微创小切口肌间隙入路椎弓根内固定术治疗。比较两组术后情况（术后下床时间、治疗费用、总住院时间）、Frankel分级、并发症发生情况、手术前后Cobb角度及椎体前缘高度比率。结果：观察组术后下床时间、治疗费用、总住院时间均明显较对照组低，差异均有统计学意义（P<0.05）；观察组术后Frankel分级中，E级占45.3%，较对照组的24.7%改善更明显，差异有统计学意义（P<0.05）；两组术后并发症主要包括切口感染、压疮、皮肤破损、椎弓根螺钉松动等，观察组并发症发生率为20.0%，对照组为43.3%，观察组明显低于对照组（P<0.05）；两组组术前Cobb角度、椎体前缘高度比率比较，差异均无统计学意义（P>0.05），术后观察组Cobb角度明显低于对照组，椎体前缘高度比率则明显高于对照组，差异均有统计学意义（P<0.05）。结论：胸腰椎脊柱骨折行新型脊柱外固定器联合微创技术治疗，可有效减少患者的术后下床时间、治疗费用、总住院时间，改善Frankel分级，降低并发症发生率及Cobb角度，提高椎体前缘高度比率，是一种有效治疗方法。%Objective:To investigate the clinical effect of new spinal external fixator combined with minimally invasive technique in the treatment of thoracolumbar spine fractures.Method:In Guangdong province were selected in Heyuan People’s Hospital from January 2012 to January 2016 were 300 cases of thoracolumbar spine fracture patients as the research object, randomly divided into control group and observation group, 150 cases in each group, the control group underwent minimally invasive paraspinal approach pedicle internal fixation, the observation group underwent new spinal fixator combined with minimally invasive paraspinal approach pedicle fixation. After the operation, the 2 groups were compared (postoperative bed time, treatment costs, total hospital stay), Frankel classification, incidence of complications, Cobb angle before and after the operation and the height of vertebral body height.Result:Postoperative ambulation time,hospitalization time and treatment costs of the observation group were significantly lower than those of the control group,there were statistical significance (P<0.05).The observation group,Frankel grade,E grade accounted for 45.3%,compared with 24.7% of the control group improved more significantly,there was statistical significance(P<0.05).Postoperative complications including incision infection,bedsore,skin damage,pedicle screw loosening,the observation group complication rate was 20.0%,it was significantly lower than 43.3% of the control group,there was statistical significance(P<0.05).There were no significant differences between two groups in preoperative Cobb angle, anterior vertebral height the ratio(P>0.05),Cobb angle of the observation group were significantly lower than those in control group,anterior vertebral height ratio was significantly higher than the control group,there were statistical significance(P<0.05).Conclusion:The treatment underwent a new spinal external fixation device combined with minimally invasive technique in thoracolumbar spine fracture patients,can effectively reduce the postoperative ambulation time,hospitalization time,the total cost of treatment,improve the grade of Frankel, reduce the incidence of complications and improve Cobb angle,anterior vertebral height ratio,is an effective treatment method.