Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Orthop Surg. 2023 Oct;15(10):2532-2539. doi: 10.1111/os.13825. Epub 2023 Aug 3.
Conventional open internal fixation surgery for thoracolumbar fractures has many complications and long recovery time. There are few clinical studies on the minimally invasive percutaneous injured vertebrae screw internal fixation. The purpose of this paper is to evaluate the application value of minimally invasive percutaneous injured vertebrae screw internal fixation in the treatment of thoracolumbar fractures (TF).
A total of 98 patients with TF admitted to our hospital from January 2019 to December 2021 were retrospectively enrolled. According to the surgical method, the patients were divided into the study group (n = 49, treated with minimally invasive percutaneous injured vertebrae screw internal fixation) and the control group (n = 49, treated with traditional open internal fixation surgery). The two groups were compared in the perioperative period, the degree of pain at different periods, the percentage of the height of the anterior edge of the injured vertebra, the Cobb angle of the injured vertebra body and the wedge angle of the injured vertebra body at the first week and the last follow-up, and the postoperative complications and the occurrence of the cone shell after the operation were recorded. Then, statistical analysis such as Student's t test or Chi-Square test was performed.
The operation time (p = 0.002), intraoperative blood loss (p < 0.001), postoperative drainage volume (p = 0.011), and length of hospital stay (p = 0.003) in the study group were significantly lower than that in the control group. The VAS in the study group (3.38 ± 1.02) was significantly lower than that in the control group (4.56 ± 1.04) on the 7th day after the operation, with a significant difference (p < 0.001). The correction values of the percentage of leading edge height (LEH), Cobb angle, wedge angle in the study group were significantly lower than that in the control group at 1 week after surgery (all ps < 0.001). The incidence of postoperative complications in the study group (one case, 2.04%) was significantly lower than that in the control group (seven cases, 14.29%) (p = 0.031). At 1 month, 6 months, 10 months, and the last follow-up, the incidence of "empty shell" on CT scan in the study group were lower than that in the control group with a significant difference (all ps < 0.05).
Applying minimally invasive percutaneous injured vertebrae screw internal fixation is more beneficial to shorten the operation time and hospital stay, with fewer postoperative complications.
传统的胸腰椎骨折切开复位内固定术并发症多，恢复时间长。微创经皮伤椎螺钉内固定术治疗胸腰椎骨折的临床研究较少。本文旨在评估微创经皮伤椎螺钉内固定术治疗胸腰椎骨折（TF）的应用价值。
回顾性分析 2019 年 1 月至 2021 年 12 月我院收治的 98 例 TF 患者的临床资料。根据手术方法，将患者分为研究组（n=49，采用微创经皮伤椎螺钉内固定术治疗）和对照组（n=49，采用传统切开复位内固定术治疗）。比较两组患者的围手术期指标、不同时期疼痛程度、伤椎前缘高度百分比、伤椎体 Cobb 角、伤椎体楔变角，记录术后并发症及术后“空壳”发生情况。然后进行 Student's t 检验或 Chi-Square 检验等统计学分析。
研究组手术时间（p=0.002）、术中出血量（p<0.001）、术后引流体积（p=0.011）和住院时间（p=0.003）明显低于对照组。术后第 7 天，研究组 VAS 评分（3.38±1.02）明显低于对照组（4.56±1.04），差异有统计学意义（p<0.001）。术后 1 周，研究组伤椎前缘高度百分比（LEH）、Cobb 角、楔变角的矫正值明显低于对照组，差异均有统计学意义（均 p<0.001）。研究组术后并发症发生率（1 例，2.04%）明显低于对照组（7 例，14.29%）（p=0.031）。术后 1 个月、6 个月、10 个月及末次随访时，研究组 CT 扫描“空壳”发生率均低于对照组，差异均有统计学意义（均 p<0.05）。
应用微创经皮伤椎螺钉内固定术治疗胸腰椎骨折，更有利于缩短手术时间和住院时间，术后并发症少。
