微创经皮穿刺椎弓根内固定术治疗胸腰椎骨折的临床疗效观察  

Effect observation of minimally invasive percutaneous pedicle screw fixation and posterior lumbar interbody fusion in the treatment of thoracolumbar fracture

作　　者：孔祥清[1] 孟纯阳[1] 张卫红[1] 曹贵君[1] 王叶新[1] 陈筱[1] 

机构地区：[1]济宁医学院附属医院脊柱外科,山东济宁272000

出　　处：《中国矫形外科杂志》2015年第8期692-695,共4页Orthopedic Journal of China

摘　　要：[目的]探讨胸腰段骨折微创经皮穿刺椎弓根内固定术（minimally invasive percutaneous pedicle screw fixation,MIPPSF）治疗的可行性及临床效果。[方法]回顾性分析2012年7月~2013年7月本科收治的无神经症状的单节段胸腰椎爆裂性骨折（T11~L2）患者21例,平均年龄38.7岁。其中高处坠落伤18例,重物压砸伤1例,交通车祸伤2例,对手术时间、术中出血量以及切口长度,手术前后VAS评分,ODI指数,后凸畸形矫正情况等进行统计。[结果]切口长度平均（1.2±0.3）cm,手术时间平均（50.3±14.7）min,术中出血量平均（20.6±8.5）ml;术前术后VAS评分、ODI指数、矢状位后凸Cobb角、矢状面指数、伤椎椎体前缘高度等差异均有统计学意义（P〈0.05）。[结论]微创经皮椎弓根螺钉内固定技术具有操作相对简便、创伤小、出血少、手术时间短、术后恢复快等近期优点,且具有与开放手术相同的疗效,是治疗胸腰椎骨折的较好选择,但远期疗效尚需进一步随访观察。[Objective]To explore the feasibility and clinical effect of minimally invasive percutaneous pedicle screw fixation treating thoracolumbar fracture.[Method]Twenty-one patients in our department with no neurological symptoms of one-phase thoracolumbar burst fracture（T11~ L2） from July 2012 to July 2013 were included in this retrospective study,aged 25 to 50 years old（average 38.7）.The thoracolumbar fracture was caused by falling injury（n = 18）,heavy pressure injury（n =1） and traffic accidents（n = 2）.A series of indices including the operative time,blood loss,length of incision,pre-and post-operative VAS（visual analogue scale） score,ODI（Oswestry disability index） as well as correction of kyphotic deformity were evaluated.[Result]The length of incision on average was 1.2 cm ± 0.3 cm,operation time was 50.3 cm ± 14.7 min,blood loss was 20.6 cm ± 8.5 ml; and significant difference was noted in terms of VAS,ODI,Cobb angle,sagittal index and the height of anteriorvertebral body in experiment group for the pre-and post-operative imaging results（P〈0.05）.[Conclusion]Minimally invasive percutaneous pedicle screw fixation has series advantages including relatively easy to operate,small trauma,less bleeding,shorter operation time,postoperative recovery quickly in the near future,and has the same efficacy with open surgery.Although minimally invasive percutaneous pedicle screw fixation is a good choice for the treatment of thoracolumbar fractures,the long-term curative effect still needs further follow-up observation.

关 键 词：微创经皮穿刺椎弓根内固定术 后路椎间融合术 胸腰椎骨折 微创技术 

分 类 号：R687.3[医药卫生—骨科学]