脊柱胸腰段骨折采用经皮后路微创椎弓根螺钉固定的疗效探讨  

Exploration on curative effect of thoracic-lumbar spine fractures treated with minimally invasive percutaneous pedicle screw fixation

作　　者：罗万荣[1] 易伟宏[1] 王敏[1] 李夏林[1] 刘东宁[1] 王尔天[1] 

机构地区：[1]广东医学院附属南山医院脊柱外科,518052

出　　处：《中国实用医药》2017年第13期12-14,共3页China Practical Medicine

基　　金：广东省自然科学基金(项目编号:S2012010008531)

摘　　要：目的探讨脊柱胸腰段骨折采用经皮后路微创椎弓根螺钉固定的临床疗效。方法 90例脊柱胸腰段骨折(单节段)患者作为研究对象,按照治疗方法不同将其分为微创组和传统组,每组45例。微创组给予经皮后路微创椎弓根螺钉固定治疗,传统组给予传统开放手术治疗,实验结束后,比较分析两组患者手术前后的影像学指标、血清肌酸激酶(CK)、C反应蛋白(CRP)水平以及并发症发生率。结果手术前微创组患者的影像学指标与传统组比较,差异无统计学意义(P>0.05)。术后3 d及术后1年的影像学指标与传统组比较有差异有统计学意义(P<0.05)。手术前微创组患者的CK、CRP水平与传统组比较,差异无统计学意义(P>0.05);手术后微创组患者的CK、CRP水平与传统组比较,差异有统计学意义(P<0.05)。微创组出现1例伤口感染患者,1例螺钉松动患者,并发症发生率为4.4%(2/45);传统组出现2例伤口感染患者,3例螺钉松动患者,3例螺钉断裂患者,并发症发生率为17.8%(8/45);两组并发症发生率差异有统计学意义(P<0.05)。结论脊柱胸腰段骨折采用经皮后路微创椎弓根螺钉固定治疗的疗效显著,安全性较高,并发症较少,值得临床推广应用。Objective To explore the clinical curative effect of thoracic-lumbar spine fractures treated with minimally invasive percutaneous pedicle screw fixation. Methods A total of 90 thoracic-lumbar spine fractures （single segment） patients as study subjects were divided by different treatment methods into minimally invasive group and traditional group, with 45 cases in each group. The minimally invasive group received minimally invasive percutaneous pedicle screw fixation for treatment, and the traditional group received traditional open surgery for treatment. After experiment, comparison and analysis were made on imaging index, serum creatine kinase （CK）, C-reactive protein （CRP） level before and after treatment and incidence of complications in two groups. Results The minimally invasive group had no statistically significant difference in imaging index comparing with traditional group （P〉0.05）. The minimally invasive group had statistically significant difference in imaging index in postoperative 3 d and 1 year comparing with the traditional group （P〈0.05）. Before surgery, the minimally invasive group had no statistically significant difference in CK and CRP level comparing with the traditional group （P〉0.05）. After surgery, the minimally invasive group had statistically significant difference in CK and CRP level comparing with the traditional group （P〈0.05）. The minimally invasive group had 1 wound infection case and 1 bolt loose case, with incidence of complications as 4.4% （2/45）, while the traditional group had 2 wound infection cases, 3 bolt loose cases and 3 screw extraction cases, with incidence of complications as 17.8% （8/45）. Both groups had statistically significant difference in incidence of complications （P〈0.05）. Conclusion Minimally invasive percutaneous pedicle screw fixation shows significant curative effect in treating thoracic-lumbar spine fractures with high safety and less complications, so it is worthy of clinical promotion and application.

关 键 词：脊柱胸腰段骨折 经皮后路微创椎弓根螺钉固定 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]