经皮椎弓根钉治疗单椎体A型胸腰椎骨折的临床疗效  

Clinical curative effect of percutaneous pedicle screw for treatment of thoracolumbar fractures

作　　者：蔡斌[1] 张文捷[1] 张震祥[1] 赵春明[1] 黄爱兵[1] 张威[1] 陆奇峰[1] 

机构地区：[1]泰州市人民医院骨科,江苏225300

出　　处：《中国骨与关节损伤杂志》2015年第5期456-459,共4页Chinese Journal of Bone and Joint Injury

基　　金：江苏大学临床医学科技发展(JLY20120127)

摘　　要：目的探讨经皮椎弓根钉固定治疗新鲜单椎体A型胸腰椎骨折的临床疗效。方法回顾性分析自2010-03—2013-06诊治的新鲜单一胸腰椎A型骨折(Magerl分型)49例。采用经皮置钉手术23例(A组);传统开放手术26例(B组)。结果切口长度:A组(7.5±0.9)cm,B组(12.7±1.3)cm(P<0.01);手术时间:A组(90.9±12.1)min,B组(123.6±16.6)min(P<0.01);术中出血量:A组(60.6±21.8)ml,B组(342.7±60.2)ml(P<0.01);术后引流量:A组(16.3±4.6)ml,B组(124.2±21.8)ml(P<0.01);2组数据比较差异有统计学意义(P<0.05)。术后住院时间:A组(15.3±2.7)d,B组(18.0±2.9)d,差异有统计学意义(P<0.05)。A组与B组的术前VAS评分差异无统计学意义(P>0.05),术后3 d、术后3周、术后3个月、术后半年,微创组疼痛明显减轻,2组同一时间比较差异有统计学意义(P<0.05)。结论经皮置钉治疗胸腰椎骨折(无需减压)的临床疗效明显优于开放手术,具有出血少、手术切口小、住院时间短、术后疼痛轻,术后疼痛恢复快等特点。Objective To explore the clinical effect of the percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures. Methods From March 2010 to June 2013, a total of 49 cases suffering from fresh single thoracolumbar fracture type A （according to Magerl type） were retrospectively analyzed. Twenty-three cases received percutaneous minimally invasive surgery, as group A; 26 cases underwent the traditional open surgery as group B. Results Incision length was （7.5~0.9）cm in group A, and （12.7＋1.3）cm in group B （P 〈0.01）; operative time was （90.9~12.1）min in group A, and （123.6＋16.6）min in group B（P 〈0.01）; blood loss was （60.6＋21.8）ml in group A, and （342.7~60.2）ml in group B （P 〈0.01）; postoperative drainage was （16.3＋4.6）ml in group A, and （124.2＋21.8）ml in group B （P 〈0.01）; hospital stay was （15.3＋2.7）d in group A, and （18.0~2.9）d in group B, the difference was statistically significant （P 〈0.05）. Three days, three weeks, three months, half year after operation, pain was significantly reducedin minimally invasive group, differences at the same time compared with the traditional open surgery group were statistically significant （P 〈0.05）. Conclusion Minimally invasive percutaneous pedicle screws without decompression pressure in the treatment of thoracolumbar fractures has better clinical curative effect than open surgery, with a small incision, less bleeding, shorter hospitalization time, small tissue injury, less postoperative pain, quicker recovery.

关 键 词：经皮 椎弓根钉固定 胸腰椎骨折 

分 类 号：R687.3[医药卫生—骨科学]