微创内固定术治疗脊柱骨折对组织创伤应激反应的影响。
Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures.
机构信息
Zibo Hospital of Shandong Yiyang Health Group, Zibo, Shandong 255051, China.
出版信息
Contrast Media Mol Imaging. 2022 Aug 16;2022:2375883. doi: 10.1155/2022/2375883. eCollection 2022.
OBJECTIVE
To analyze the influence of minimally invasive arch root nailing internal fixation surgery on tissue traumatic stress response in patients with vertebral fractures and explore the advantages of this treatment.
METHODS
One hundred and thirty-six patients with vertebral fractures admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups based on the treatment method: the control group was treated with open arch root nail internal fixation surgery and the study group was treated with minimally invasive arch root nail internal fixation. The lumbar spine function, ODI, VAS, JOA score, complications, inflammation, and stress response were compared between the two groups.
RESULTS
After the operation, the ratio of intervertebral space and anterior edge height increased, and the Cobb angle decreased in both groups; the surgical incision, hospital stay, and operation time in the study group were shorter than those in the control group, and the intraoperative drainage volume and intraoperative blood loss were smaller than those in the control group ( < 0.05); before surgery, there was no significant difference in ODI and VAS scores between the two groups ( > 0.05). After surgery, the ODI and VAS scores in the two groups were significantly decreased, and the JOA score was significantly increased; complications occurred in the control group and the study. The incidence of complications in the study group was lower than that in the control group ( < 0.05); after surgery, compared with the control group, the serum TNF-, CRP levels, and stress response indexes of the study group decreased more significantly ( < 0.05).
CONCLUSION
Minimally invasive pedicle screw fixation has high safety and obvious advantages. The patient's stress response index and pain level are low, and it will not cause obvious damage to the patient. The postoperative lumbar spine function is significantly improved, which is beneficial to the patient's postoperative recovery. It is easy to operate, will not damage the thoracic and lumbar vertebrae significantly, and the fluoroscopy time is relatively short, and it has a good recovery effect. Therefore, minimally invasive internal arch nailing surgery can be used as the preferred treatment for patients with vertebral fractures.
目的
分析微创椎弓根钉内固定术对椎体骨折患者组织创伤应激反应的影响,并探讨该治疗方法的优势。
方法
选取我院 2020 年 1 月至 2022 年 1 月收治的 136 例椎体骨折患者,根据治疗方法分为两组:对照组采用开放式椎弓根钉内固定术治疗,观察组采用微创椎弓根钉内固定术治疗。比较两组患者的腰椎功能、ODI、VAS、JOA 评分、并发症、炎症和应激反应。
结果
术后两组椎间间隙比、前缘高度增加,Cobb 角减小;观察组手术切口、住院时间、手术时间均短于对照组,术中引流量、术中出血量均小于对照组(<0.05);术前两组 ODI、VAS 评分比较,差异无统计学意义(>0.05)。术后两组 ODI、VAS 评分均降低,JOA 评分升高;对照组和观察组均出现并发症,观察组并发症发生率低于对照组(<0.05);术后观察组血清 TNF-、CRP 水平及应激反应指标较对照组下降更明显(<0.05)。
结论
微创椎弓根螺钉内固定术安全性高,优势明显。患者的应激反应指标和疼痛程度较低,且不会对患者造成明显损伤。术后腰椎功能明显改善,有利于患者术后恢复。操作简单,对胸腰椎损伤小,透视时间相对较短,恢复效果好。因此,微创内弓根钉术可作为椎体骨折患者的首选治疗方法。