Sextant经皮椎弓根螺钉固定矫正胸腰椎单节段椎体骨折（英文）  

Sextant percutaneous pedicle screw fixation for correcting single-segment thoracolumbar fractures

作　　者：明江华[1] 郑慧锋[1] 赵奇[1] 陈庆[1] 王钢[1] 

机构地区：[1]武汉大学人民医院骨科,湖北省武汉市430060

出　　处：《中国组织工程研究》2014年第35期5654-5659,共6页Chinese Journal of Tissue Engineering Research

基　　金：the grants from Renmin Hospital of Wuhan University,No.2012hx0028~~

摘　　要：背景:虽然保守与传统开放复位内固定治疗胸腰椎骨折的疗效通常是可靠和令人满意的,但其也存在诸多不足。微创经皮椎弓根系统为胸腰椎骨折的治疗提供了新的方法。目的:观察Sextant经皮椎弓根螺钉系统治疗胸腰椎骨折的临床效果。方法:共纳入55例患者,均因单个椎体的单纯压缩性骨折于2011年2月至2013年1月在武汉大学人民医院骨科分别行Sextant经皮椎弓根螺钉固定(25例)和传统开放复位内固定(30例)。结果与结论:除开放复位内固定组2例患者出院后失访外,其余患者均获得随访,随访时间为8-14个月。行Sextant经皮椎弓根螺钉固定患者的手术时间、术中失血量、术后引流量和住院天数均显著优于传统开放复位内固定治疗的患者(P<0.05);行Sextant经皮椎弓根螺钉固定和传统开放复位内固定的患者内固定后矢状位Cobb角、目测类比评分和功能障碍指数问卷表评分均显著低于内固定前(P<0.05),而椎体前缘高度百分比显著高于内固定前(P<0.05);两组患者内固定后8个月随访时的矫正丢失量和功能障碍指数问卷表评分差异无显著性意义(P>0.05)。提示Sextant经皮椎弓根螺钉系统治疗胸腰椎单节段椎体骨折矫正效果满意,但临床应用时需掌握其准确适应证。BACKGROUND：Though the effects of conservative or traditional open reduction and internal fixation in the treatment of thoracolumbar fractures are reliable and satisfactory for most cases, two methods also have shortages. Minimal-invasive percutaneous pedicle screw system provides a new available method. OBJECTIVE：To investigate the clinical effect of Sextant percutaneous pedicle screw system in the treatment of thoracolumbar fractures. METHODS：A total of 55 patients, who had undergone percutaneous pedicle screw fixation using Sextant system （25 patients） or traditional open internal fixation （30 patients） for single-level vertebral body compression fractures in Department of Orthopedics of Renmin Hospital of Wuhan University from February 2011 to January 2013, were enrol ed in this study. RESULTS AND CONCLUSION：Except two patients in traditional open internal fixation group were lost after discharge, al other patients were fol owed up for 8-14 months. Operative time, intraoperative blood loss, postoperative drainage amount and hospital day were better in percutaneous pedicle screw fixation group than in the traditional open internal fixation group （P〈0.05）. Compared with preoperation, the sagittal Cobb angle, visual analogue scale and Oswestry disability index after operation were significantly lower （P〈0.05）, while anterior vertebral body height ratio was significantly higher in each group （P〈0.05）. No significant difference was found in terms of correction loss and Oswestry disability index between two groups at 8 months after operation （P〉0.05）. The results show that percutaneous pedicle screw fixation using Sextant system has a satisfactory outcome in the treatment of thoracolumbar fractures. However, obeying indication strictly is very important for clinical application.

关 键 词：植入物 脊柱植入物 内固定 胸椎 腰椎 脊柱骨折 内固定器 压缩骨折 Sextant经皮椎弓根螺钉固定 开放复位内固定 

分 类 号：R318[医药卫生—生物医学工程]