摘要目的:探究与分析经皮微创与开放式椎弓根钉内固定治疗脊椎骨折的临床效果。方法:选取2018年6月至2020年6月滨州市中心医院骨外科收治的103例脊椎骨折患者，男53例，女50例，年龄(41.25±4.77)岁，年龄范围为23～65岁。按照不同内固定治疗方法分为经皮微创组( n＝49)与开放式组( n＝54)。经皮微创组采用经皮微创椎弓根钉内固定术，开放式组采用开放式椎弓根钉内固定术，比较两组患者围术期指标、并发症发生情况、治疗前后Oswestry功能障碍指数(ODI)及影像学指标。 结果:经皮微创组手术时间[(118.25±18.43)min]长于开放式组[(65.58±5.61)min]，术中出血量[(26.57±3.44)ml]少于开放式组[(170.59±25.39)ml]，切口长度[(1.45±0.23)cm]、术后下地锻炼时间[(2.15±0.26)d]、骨折愈合时间[(13.24±0.54)d]、住院时间[(5.41±1.15)d]均短于开放式组[(10.46±1.33)cm、(11.58±0.67)d、(17.18±0.83)d、(10.89±1.35)d]，差异均有统计学意义( P<0.05)。经皮微创组并发症发生率[8.2%(4/49)]与开放式组[5.6%(3/54)]比较，差异无统计学意义( P>0.05)。治疗后，经皮微创组ODI[(27.28±6.24)分]低于开放式组[(38.97±5.60)分]，差异有统计学意义( P<0.001)，经皮微创组Cobbs角[(6.15±0.65)°]、椎体前缘高度[(89.44±2.14)%]与开放式组[(6.10±0.34)°、(90.12±3.24)%]比较，差异无统计学意义( P>0.05)。但两组患者治疗后ODI、Cobbs角均低于治疗前，椎体前缘高度均高于治疗前，差异均有统计学意义( P<0.05)。 结论:经皮微创内固定治疗脊椎骨折对患者造成的损伤较小，不易引起并发症，可更好促进预后，影像学指标表现好。

abstractsObjective:To investigate and analyze the clinical effect of percutaneous minimally invasive and open pedicle screw internal fixation in the treatment of spinal fractures.Methods:From June 2018 to June 2020, 103 patients with spine fractures who were admitted to the department of Orthopedics of Binzhou Central Hospital were selected, 53 males and 50 females, aged(41.25±4.77)years old, and the age range was 23 to 65 years old.According to different internal fixation treatment methods, patients were divided into the percutaneous minimally invasive group( n=49)and open group( n=54). The percutaneous minimally invasive group of patients were performed percutaneous minimally invasive pedicle screw internal fixation, and the open group of patients were performed open pedicle screw internal fixation.The perioperative indicators, complications, Oswestry back disability index(ODI)and imaging indicators before and after treatment were compared between the two groups. Results:The operation time[(118.25±18.43)minutes]of the percutaneous minimally invasive group was longer than that of the open group[(65.58±5.61)minutes], and the intraoperative blood loss[(26.57±3.44)ml]was less than that of the open group[(170.59±25.39)ml], incision length[(1.45±0.23)cm], postoperative exercise time[(2.15±0.26)days], fracture healing time[(13.24±0.54)days], hospitalization time[(5.41±1.15)days]of the percutaneous minimally invasive group were shorter than those of the open group[(10.46±1.33)cm, (11.58±0.67)days, (17.18±0.83)days and(10.89±1.35)days], and the differences were statistically significant( P<0.05). The complication rate of the percutaneous minimally invasive group[8.2%(4/49)]compared with the open group[5.6%(3/54)], the difference was not statistically significant( P>0.05). After treatment, the ODI[(27.28±6.24)points]of the percutaneous minimally invasive group was lower than that of the open group[(38.97±5.60)points], the difference was statistically significant( P<0.001). There was no statistically significant difference between the Cobbs angle of the percutaneous minimally invasive group[(6.15±0.65)°], the height of the front edge of the cone[(89.44±2.14)%]and the open group[(6.10±0.34)°, (90.12±3.24)%], ( P>0.05). However, after treatment, the ODI and Cobbs angle of the two groups of patients were lower than those before treatment, and the height of the front edge of the cone was higher than that before treatment, and the differences were statistically significant( P<0.05). Conclusion:Percutaneous minimally invasive internal fixation in the treatment of spinal fractures causes less injury, is not easy to cause complications, can better promote the prognosis, imaging index performance is good.