脊柱创伤微创手术的临床效果。

IF 0.9 4区 医学 Q3 SURGERY Annali italiani di chirurgia Pub Date : 2024-01-01 DOI:10.62713/aic.3546
Gaochen Wu, Jinpeng Chen, Lulu Wang, Fanjian Meng
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引用次数: 0

摘要

目的:微创脊柱创伤手术包括经皮椎弓根螺钉固定术和基于前外侧牵引器的微型开放式手术,可通过减少失血量、手术时间和术后疼痛改善手术效果。因此,本研究旨在评估微创手术对脊柱创伤患者疼痛评分、功能恢复和术后并发症的影响:本回顾性研究纳入了2019年5月至2022年5月期间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为传统组,接受经皮椎弓根螺钉内固定联合后路微创小切口减压术的患者为研究组,各50例。通过评估这两种手术方法的疗效,包括手术相关指数、术后疼痛、脊柱形态、功能恢复和术后并发症等:结果:与开放手术相比,微创手术的手术伤口、住院时间、手术时间和术后离床活动时间明显缩短,术中出血量和术后引流量也更少(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个月的视觉模拟量表(VAS)评分明显降低,术后7天和3个月的Oswestry功能障碍指数(ODI)也明显降低(P<0.05)。此外,两组患者脊柱形态的差异未达到统计学意义(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:微创手术对脊柱创伤患者造成的手术损伤更小,可改善手术相关指标,减轻术后疼痛,使脊柱的形态和功能得到更好的恢复。
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Clinical Effectiveness of Minimally Invasive Surgery on Spinal Trauma.

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.

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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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