微创经皮置钉技术治疗胸腰椎骨折的临床疗效  

Clinical effects of minimal-invasive percutaneous pedicle screw fixation in management of thoracolumbar fractures

作　　者：卢政好[1] 欧军[1] 苏小桃[1] 谭健[1] 何俊[1] 吴志良[1] 刘静男[1] 

机构地区：[1]南华大学附属南华医院脊柱外科,湖南衡阳421002

出　　处：《临床骨科杂志》2016年第5期518-521,共4页Journal of Clinical Orthopaedics

摘　　要：目的：探讨微创经皮置钉技术（ MIPPSF）治疗胸腰椎骨折的临床疗效。方法将89例单节段胸腰椎骨折患者按照椎弓根置钉方法分成MIPPSF组（ A组,36例）和开放手术椎弓根螺钉内固定技术（ OPSF）组（ B组,53例）。比较两组患者切口长度、手术时间、术中出血量、术后3 d VAS评分、术后1年伤椎前缘高度比和矢状面Cobb角评价内固定失败率和Oswestry功能障碍指数（ ODI）。结果患者均获得随访,时间12-18个月。两组切口长度、手术时间、术中出血量和术后3 d VAS评分A组均少于B组,差异均有统计学意义（ P〈0．05）；术后1年伤椎前缘高度比、矢状面Cobb角、内固定失败率和ODI两组比较差异均无统计学意义（ P〉0．05）。结论 MIPPSF治疗胸腰椎骨折创伤小,治疗效果与OPSF相似。Objective To investigate the clinical effects of minimal-invasive percutaneous pedicle screw fixation （ MIPPSF） in management of thoracolumbar fractures. Methods Eighty-nine patients with single-segment thoraco-lumbar fractures were divided into two groups according to the operative methods：MIPPSF group（Group A,n=36） and open pedicle screw fixation（OPSF） group（Group B,n=53）. The incision length,operative time,blood loss,VAS on the 3rd day postoperatively,the fractured vertebral height ratio and Cobb′s angle in 1 year postoperatively were compared between two groups. The internal fixation failure rate and Oswestry disability index（ ODI） in 1 year postop-eratively were evaluated. Results All the cases had been followed up for 12-18 months. Group A had shorter inci-sion length and operative time,lower blood loss and VAS on the 3rd day postoperatively and there were significant difference compared with group B（P〈0. 05）. The fractured vertebral height ratio,Cobb′s angle,internal fixation fail-ure rate and ODI in 1 year postoperatively had no significant difference between the two groups（P〉0. 05）. Conclu-sions In management of thoracolumbar fractures,MIPPSF can be minimal injury,meanwhile it can achieve the simi-lar clinical effects with OPSF.

关 键 词：经皮微创置钉 开放椎弓根螺钉内固定 胸腰椎骨折 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]