微创经椎弓根螺钉内固定术治疗胸腰椎骨折的疗效  

A Comparative Study of the Efficacy of Minimally Invasive and Traditional Open Additional Vertebral Pedicle Screw Fixation Surgical Treatment of Thoracolumbar Fractures

作　　者：吉浩宇[1] 

机构地区：[1]内蒙古医科大学附院,内蒙古呼和浩特010050

出　　处：《贵阳医学院学报》2015年第9期978-981,共4页Journal of Guiyang Medical College

摘　　要：目的:比较微创与传统方法附加伤椎经椎弓根螺钉内固定术治疗胸腰椎骨折的疗效。方法:将52例胸腰椎骨折患者随机分为观察组和对照组,观察组采用微创经皮手术进行治疗,对照组行传统开放手术治疗,均行附加伤椎经椎弓根螺钉内固定手术;观察两组患者的切口长度、手术时间、住院时间、出血量、引流量,比较手术前后Cobb’s角、伤椎后凸角、伤椎前缘高度及矢位指数。结果:观察组的切口长度、手术时间、术后住院时间短于对照组,术中出血量、术后引流量少于对照组,术后伤口评分也优于对照组(P<0.05);两组患者术后Cobb’s角及伤椎后凸角小于术前,矢位指数大于术前(P<0.05),但两组间比较差异无统计学意义(P>0.05),术后两组伤椎前缘高度优于术前,且对照组优于观察组(P<0.05)。结论:微创附加伤椎经椎弓根螺钉内固定手术治疗胸腰椎骨折创伤小,恢复快,对伤椎畸形的矫正和内固定效果达到传统手术方法的水平。Objective ： To compare the curative effect of treatment of thoracolumbar fracture by mini- mally invasive surgery combined with vertebral pedicle screw fixation surgery and by traditional open surgery combined with vertebral pedicle screw fixation surgery. Methods： Fifty-two patients with thoracolumbar fracture were divided into observation group （26 cases） and control group （26 cases）. The observation group were treated with minimally invasive percutaneous surgery while the control group treated with traditional open surgery, and both groups underwent additional vertebral pedicle screw fix- ation surgery. The operation time, incision length, postoperative length of hospital stay, blood loss and postoperative drainage were observed in both groups. Cobb~ angle, posterior convex angle of thoraco- lumbar vertebrae, leading edge height of injured vertebrae, sagittal index in both groups were com- pared. Results： Compared with control group, incision length of the observation group, operation time, postoperative length of hospital stay of observation group were significantly shorter, peroperative bleeding and postoperative drainage were less, and postoperative wound score was better （P 〈 0.05 ）. Postperative Cobb$ angle and posterior convex angle of thoracolumbar vertebrae were larger than their preoperative counterparts while sagittal index was smaller than preoperative index in both groups, but there were no statistical differences between control group and observation group （ P 〉 0.05 ）. Postoperative leading edge height of injured vertebrae was better than preoperative height in both groups, and this index was better in control group compared with observation group （ P 〈 0.05 ）. Conclusion： The treatment of thoraeolumbar fractures by minimally invasive surgery combined with vertebral pedicle screw fixation surgery shows its advantages, including less trauma, shorter operative time, less blood loss, shorter hospital stay, less disease complications, and quick patient recovery. And

关 键 词：脊柱骨折 骨折固定术 内 外科手术 

分 类 号：R683.2[医药卫生—骨科学]