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微创脊柱创伤手术的临床疗效。

Clinical Effectiveness of Minimally Invasive Surgery on Spinal Trauma.

机构信息

Department of Orthopaedics, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, 215101 Suzhou, Jiangsu, China.

出版信息

Ann Ital Chir. 2024;95(4):552-560. doi: 10.62713/aic.3546.

Abstract

AIM

Minimally invasive spinal trauma surgery includes percutaneous pedicle screw fixation and miniature open anterolateral retractor-based approaches, which can improve surgical outcomes by reducing blood loss, operative time, and postoperative pain. Therefore, this study aimed to evaluate the effect of minimally invasive surgery on pain scores, functional recovery, and postoperative complications in patients with spinal trauma.

METHODS

This retrospective study included 100 spinal trauma patients treated in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine between May 2019 and May 2022. Patients who underwent traditional open surgery were included in the traditional group, and those who received percutaneous pedicle screw internal fixation combined with posterior minimally invasive small incision decompression were included in the research group, each comprising 50 patients. The effectiveness of these two surgical approaches was determined by assessing their outcome measures, including surgery-related indices, postoperative pain, spinal morphology, functional recovery, and postoperative complications.

RESULTS

Minimally invasive surgery was associated with significantly shorter surgical wounds, length of hospital stay, operative time, and postoperative time-lapse before off-bed activity, and less intraoperative hemorrhage volume and postoperative drainage volume compared to open surgery (p < 0.001). Compared to open surgery, patients with minimally invasive surgery showed significantly lower visual analogue scale (VAS) scores at 3 days, 3 months, and 6 months after surgery and lower Oswestry dysfunction index (ODI) at 7 days and 3 months after surgery (p < 0.05). Furthermore, the difference in the spine morphology between the two arms did not achieve statistical significance (p > 0.05). Additionally, minimally invasive surgery resulted in a significantly lower incidence of postoperative complications than open surgery (p < 0.05).

CONCLUSIONS

Minimally invasive surgery causes less surgical damage for patients with spinal trauma, improves surgery-related indexes, alleviates postoperative pain, and provides better morphological and functional recovery of the spine.

摘要

目的

微创脊柱创伤手术包括经皮椎弓根螺钉固定和微型前路撑开器入路,可通过减少出血量、手术时间和术后疼痛来改善手术结果。因此,本研究旨在评估微创对脊柱创伤患者疼痛评分、功能恢复和术后并发症的影响。

方法

这是一项回顾性研究,纳入了 2019 年 5 月至 2022 年 5 月在苏州市中西医结合医院接受治疗的 100 例脊柱创伤患者。接受传统开放手术的患者纳入传统组,接受经皮椎弓根螺钉内固定联合后路微创小切口减压的患者纳入研究组,每组各 50 例。通过评估手术相关指标、术后疼痛、脊柱形态、功能恢复和术后并发症等,来确定这两种手术方法的效果。

结果

与开放手术相比,微创手术的手术切口、住院时间、手术时间和离床活动时间明显缩短,术中出血量和术后引流量明显减少(p<0.001)。与开放手术相比,微创手术患者术后 3 天、3 个月和 6 个月的视觉模拟评分(VAS)明显较低,术后 7 天和 3 个月的 Oswestry 功能障碍指数(ODI)明显较低(p<0.05)。此外,两组脊柱形态的差异没有达到统计学意义(p>0.05)。此外,微创手术的术后并发症发生率明显低于开放手术(p<0.05)。

结论

微创脊柱创伤手术对脊柱创伤患者的手术损伤较小,改善了手术相关指标,减轻了术后疼痛,为脊柱提供了更好的形态和功能恢复。

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