Comparison of effects of percutaneous minimally invasive pedicle screw internal fixation and open pedicle screw internal fixation in treatment of elderly patients with spinal fractures
Objective:To compare effects of percutaneous minimally invasive pedicle screw internal fixation and open pedicle screw internal fixation in treatment of elderly patients with spinal fractures. Methods:A prospective study was conducted on 80 elderly patients with spinal fractures admitted to the third affiliated hospital of Nanyang medical college from January 2021 to October 2023. They were divided into control group (n=40) and observation group (n=40) by using the random number table method. The control group was treated with open pedicle screw internal fixation,while the observation group was treated with percutaneous minimally invasive pedicle screw internal fixation. The perioperative indexes (operation time,surgical incision,intraoperative blood loss,postoperative bed rest time,postoperative hospitalization time) levels,the imaging indexes[kyphosis angle (Cobb),sagittal index (SI),anterior vertebral height]levels,the pain stress response indexes[serum substance P (SP),cortisol (Cor),interleukin-6 (IL-6)]levels,the spinal function[Oswestry dysfunction index (ODI)]score,the activities of daily living[activity of daily living (ADL)]score before and after the surgery,and the incidence of postoperative complications were compared between the two groups. Results:The operation time,surgical incision,postoperative bed rest time and postoperative hospitalization time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the differences were statistically significant (P<0.05). Three months after the surgery,the Cobb angle of the two groups were smaller than those before the treatment,and that in the observation group was smaller than that in the control group;the levels of SI and anterior vertebral height in the two groups were higher than those before the surgery,and those in the observation group were higher than those in the control group;and the differences were statistically significant (P<0.05). Three days after the surgery,the levels of SP,Cor and IL-6 in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant (P<0.05). Three months after the surgery,the ODI scores of the two groups were lower than those before the surgery,and that in the observation group was lower than that in the control group;the ADL scores of the two groups were higher than those before the surgery,and that in the observation group was higher than that in the control group;and the differences were statistically significant (P<0.05). Further,the incidence of postoperative complications in the observation group was lower than that in the control group,and the difference was statistically significant (P<0.05). Conclusions:Percutaneous minimally invasive pedicle screw internal fixation in the treatment of the elderly patients with spinal fractures can improve the activities of daily living scores,improve the imaging index and perioperative index levels,and reduce the stress response index levels,spinal dysfunction scores and incidence of complications. Moreover,it is superior to open pedicle screw internal fixation.
ElderlySpinal fracturePercutaneous minimally invasive pedicle screw internal fixationOpen pedicle screw internal fixationSpinal functionActivity of daily living scorePain
万方数据
维普
