Weng Fengbiao, Wang Jiazi, Yang Liwen, Zeng Jincai, Chu Yawei, Tian Zhigang
Department of Orthopaedics, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200, P.R. China.
Exp Ther Med. 2018 Aug;16(2):665-670. doi: 10.3892/etm.2018.6248. Epub 2018 Jun 1.
Clinical value of expansive pedicle screw in lumbar short-segment fixation and fusion for patients with osteoporosis was investigated. A total of 80 patients with lumbar compression fracture but without obvious nerve compression were selected and divided into the observation group (n=40) and the control group (n=40) using a random number table. The observation group used the expansive pedicle screw, and the control group received conventional pedicle screw fixation and bone graft fusion. In the observation group, the operation and hospitalization time after operation were shorter and the intraoperative bleeding amount was less than that in control group (p<0.05). At 1 week, 1, 3 and 6 months after operation, the observation group had better straight leg raising test (SLRT) scores, higher lower limb sensory scores but lower visual analogue scale (VAS) scores than control group (p<0.05). Besides, the proportions of postoperative infection, dural mater tear, nerve root injury and spinal cord injury during operation in the observation group were lower than those in the control group (p<0.05), and the bone graft fusion rates at 3 and 6 months after operation were obviously superior to those in control group (p<0.05). Moreover, after operation, the spinal stenosis rate in the observation group was lower than that in control group (p<0.05), the vertebral height ratio was larger than that in control group (p<0.05), and the Cobb's angle was smaller than that in the control group (p<0.05). In addition, there was a negative correlation between bone mineral density (BMD) and hospitalization time after operation in the observation group (p<0.05). In conclusion, the internal fixation with expansive pedicle screw for osteoporosis patients with lumbar compression fracture is characterized by short operation time, less intraoperative bleeding, few complications, quick recovery of postoperative neurological function and satisfactory surgical effect. However, reasonable intervention in osteoporosis is also necessary.
探讨膨胀式椎弓根螺钉在骨质疏松性腰椎短节段固定融合中的临床价值。选取80例无明显神经受压的腰椎压缩性骨折患者,采用随机数字表法分为观察组(n = 40)和对照组(n = 40)。观察组采用膨胀式椎弓根螺钉,对照组采用传统椎弓根螺钉固定并植骨融合。观察组手术及术后住院时间短于对照组,术中出血量少于对照组(p<0.05)。术后1周、1、3和6个月,观察组直腿抬高试验(SLRT)评分更好,下肢感觉评分更高,但视觉模拟评分(VAS)更低(p<0.05)。此外,观察组术后感染、硬脑膜撕裂、神经根损伤及术中脊髓损伤的发生率低于对照组(p<0.05),术后3个月和6个月的植骨融合率明显优于对照组(p<0.05)。而且,术后观察组椎管狭窄率低于对照组(p<0.05),椎体高度比值大于对照组(p<0.05),Cobb角小于对照组(p<0.05)。另外,观察组骨密度(BMD)与术后住院时间呈负相关(p<0.05)。综上所述,膨胀式椎弓根螺钉内固定治疗骨质疏松性腰椎压缩性骨折具有手术时间短、术中出血少、并发症少、术后神经功能恢复快、手术效果满意等特点。然而,对骨质疏松症进行合理干预也是必要的。