RTS和SEXTANT经皮微创椎弓根螺钉置入修复不稳定胸腰椎骨折:椎体复位高度比较  

RTS versus SEXTANT percutaneous pedicle screw fixation for unstable thoracolumbar fractures under minimally invasive technology:recovery of the height of the vertebral body

作　　者：赵刚[1] 周英杰[1] 王许可[1] 

机构地区：[1]河南省洛阳正骨医院脊柱外科,河南省洛阳市471002

出　　处：《中国组织工程研究》2016年第22期3255-3262,共8页Chinese Journal of Tissue Engineering Research

基　　金：河南省重点中医学科学术带头人基金培养项目(2100601)~~

摘　　要：背景:目前随着微创技术的发展,经皮椎弓根内固定技术的应用趋于广泛,但在胸腰椎骨折的经皮椎弓根螺钉固定中,因后路撑开复位装置的缺乏或复位力量较弱的缺陷,导致对伤椎的复位较差,为改进这一缺陷,对经皮椎弓根螺钉进行了改进,以期能够达到理想的复位效果。目的:以伤椎复位高度的角度对比RTS和SEXTANT两种经皮椎弓根螺钉修复不稳定胸腰椎骨折的效果差异。方法:2011年10月至2013年6月分别采用2种经皮椎弓根螺钉系统修复单节段无神经症状的胸腰椎骨折患者50例,其中25例使用Sextant系统,25例使用改良的RTS系统。分别比较2组间治疗后1周、3个月、6个月及末次随访的伤椎前、后缘高度、后凸Cobb角、目测类比评分及Oswestry功能障碍指数。结果与结论:12组患者均获得8-18个月的随访;22组患者的治疗后伤椎前、后缘高度、后凸Cobb角较治疗前均有恢复,差异有显著性意义(P<0.01);RTS组治疗后伤椎前缘、椎体后缘、后凸Cobb角恢复情况明显优于SEXTANT组(P<0.05-0.01);3RTS组治疗后6个月及末次随访目测类比评分及Oswestry功能障碍指数均显著优于SEXTANT组(P<0.05);4结果提示,RTS和SEXTANT两种经皮椎弓根螺钉系统均能有效修复无神经症状的胸腰椎单节段骨折,但RTS组具有椎体复位高度更理想,修复后疼痛和功能障碍更轻微的优点。BACKGROUND：In recent years,with the development of minimally invasive techniques,the application of percutaneous pedicle screw fixation techniques gradually become widespread,but in the percutaneous pedicle screw fixation for thoracolumbar fractures,due to lack of reduction apparatus or power defect,the reduction of the injured vertebra is poor.In order to improve this deficiency,we design a percutaneous pedicle screw system in order to achieve the desired effect of reduction.OBJECTIVE：To investigate the two different effects for treating unstable thoracolumbar fractures by fixing RTS（rotation softened trauma fixation system） or SEXTANT screws under minimally invasive technology.METHODS：From October 2011 to June 2013,50 patients who suffered from single-segment thoracolumbar fractures without any nerve-injured symptoms were treated by using percutaneous pedicle screws.Among them,25 cases used Sextant screws;the others used RTS screws.Data were compared between the two groups,including the height of injured vertebrae,Cobb＇s angle,visual analogue scale scores and Oswestry disability index 1 week,3 and 6 months postoperatively,and during final follow-up.RESULTS AND CONCLUSION：（1） All patients were followed up for 8-18 months.（2） The height of injured vertebrae and Cobb＇s angle were restored in both groups,showing significant differences（P〈0.01）.The restoration of the height of injured vertebrae and Cobb＇s angle was better in the RTS group than in the SEXTANT group after treatment（P〈0.05-0.01）.（3） The visual analogue scale scores and Oswestry disability index were significantly better in the RTS group than in the SEXTANT group 6 months postoperatively and during final follow-up（P〈0.05）.（4） These results suggest that both RTS and SEXTANT systems can effectively repair single-segment thoracolumbar fractures without any nerve-injured symptoms.However,it is clear that the recovery of the height of the vertebral body is more satisfied and the postoperative pain and dysfu

关 键 词：胸椎 腰椎 脊柱骨折 内固定器 随访研究 组织工程 骨科植入物 脊柱植入物 内固定 微创性 

分 类 号：R318[医药卫生—生物医学工程]