微创经皮椎弓根置钉治疗无神经损伤胸腰椎骨折  

Treatment of thoracolumbar fractures without neural injury by minimal-invasive percutaneous pedicle screw fixation

作　　者：卫秀洋[1] 陈勇忠[1] 王金星[1] 黄哲[1] 

机构地区：[1]福州总医院476医院骨科,福建福州350002

出　　处：《临床骨科杂志》2016年第2期137-140,共4页Journal of Clinical Orthopaedics

基　　金：南京军区医学科技创新课题(编号:11MB028)

摘　　要：目的探讨微创经皮椎弓根螺钉内固定治疗无神经损伤性胸腰椎骨折的手术方法及临床疗效。方法68例无神经系统症状胸腰椎骨折患者按手术方式分微创经皮置钉（微创组,36例）和传统开放置钉（传统组,32例）。对两组手术时间、切口长度、出血量、腰部疼痛VAS评分、伤椎前缘高度、Cobb角、置钉位置进行观察和评估。结果患者均获得随访,时间为16~27（21.4±3.35）个月。手术时间、切口长度、出血量、下地时间微创组较传统组均显著减少（P〈0.05）。Cobb角、椎体前缘高度：两组术后1周、末次随访与术前比较差异均有统计学意义（P〈0.05）;两组间比较差异无统计学意义（P〉0.05）。患者腰部疼痛术后1周微创组较传统组明显减轻,差异有统计学意义（P〈0.05）,末次随访时两组间差异无统计学意义（P〉0.05）。置钉优良率两组比较差异无统计学意义（P〉0.05）。结论微创经皮椎弓根螺钉内固定术治疗无神经损伤性胸腰椎骨折的临床疗效良好。Objective To investigate the surgical method and clinical effect of thoracolumbar fractures without neural injury treated by minimal-invasive percutaneous pedicle screw fixation. Methods 68 patients of thoracolumbar fracture without neurologic signs and symptoms were analyzed retrospectively. All patients were divided into minimally invasive surgery group（ 36 cases） and conventional group（ 32 cases）. The operative time,bleeding,length of incision,pain visual analogue scale（ VAS）,the height of anterior edge of vertebral body and the Cobb angle were observed and evaluated. Results The follow-up time was 16 ~ 27（ 21. 4 ± 3. 35） months. Minimally invasive had less operative time,less bleeding,tiny length of incision rapid ambulation time. The height of anterior edge of vertebral body and the Cobb’s angle significantly improved postoperatively. Postoperative one week and the last follow-up,compared with the preoperative,differences were statistically significant（ P 〈 0. 05）; but there was no statistical significance between two groups（ P 〉 0. 05）. Postoperative one week,pain minimally invasive group was significantly reduced,compared with the conventional group,the difference was statistically significant between the two groups（ P 〈 0. 05）. There was no statistical differences between the two groups at last follow-up（ P 〉 0. 05）. Excellent-good rate of pedicle screws showed no statistical difference between two groups（ P 〉 0. 05）. Conclusions Minimal-invasive percutaneous pedicle screw fixation achieve good clinical efficacy to treat thoracolumbar fractures without neural injury.

关 键 词：经皮椎弓根钉内固定 胸腰椎骨折 

分 类 号：R683.2[医药卫生—骨科学] R687.32[医药卫生—外科学]