3种术式治疗单节段无神经症状胸腰椎骨折的疗效比较  

Effects comparison of Quadrant channel,open fixation and percutaneous Sextant internal fixation on surgical injury and repair in patients with thoracolumbar fracture without neurological symptoms

作　　者：江昭林[1] 赵文[1] 魏朝阳[1] 

机构地区：[1]解放军海军安庆医院骨外科,安徽安庆246003

出　　处：《临床骨科杂志》2017年第4期402-405,共4页Journal of Clinical Orthopaedics

摘　　要：目的比较开放手术、Quadrant通道及Sextant 3种内固定治疗单节段无神经症状胸腰椎骨折的临床效果。方法将102例单节段无神经症状胸腰椎骨折患者按治疗方法分为A组(开放内固定,35例)、B组(Quadrant通道内固定,31例)及C组(Sextant内固定,36例)。对3组围手术期指标、影像学指标及治疗效果进行比较。结果 B、C两组切口长度、术中出血量、手术时间、住院时间、下地时间均优于A组(P<0.05),但B、C两组X线暴露时间明显长于A组(P<0.05),C组切口长度、术中出血量、下地时间均优于B组(P<0.05)。3组术后3 d及6个月病椎前缘高度、Cobb角、矢状位指数均较术前显著恢复(P<0.05),术后6个月较术后3 d均下降,但差异均无统计学意义(P>0.05);3组之间术后3 d及6个月3项指标比较差异均无统计学意义。与术前相比,3组术后6个月ODI、VAS评分均显著下降,差异均有统计学意义(P<0.05);术后6个月,B、C组治疗效果优于A组(P<0.05),C组优于B组(P<0.05)。3组患者术后并发症差异均无统计学意义(P>0.05)。结论采用微创技术结合Quadrant通道治疗单节段无神经症状胸腰椎骨折患者疗效确切,并减少手术创伤。Objective To investigate the effects of open fixation, Quadrant channel and percutaneous Sextant internal fixation on surgical injury and repair patients with thoracolumbar fracture without neurological symptoms. Methods The 102 cases with single segment thoracolumbar spine fracture without neurological symptoms were selected,and di-vided into group A （open fixation group） , group B （Quadrant channel fixation group） and group C （Sextant fixation group） . After surgery, three groups of patients with perioperative indicators, imaging indicators and treatment effects were compared. Results Compared with group A, group B and group C in the incision length, blood loss, surgery time and hospital stay, start time of walk and other indicators significantly improved, and group B and C were better than group A,while the X-ray exposure time was significantly longer than group A（P 〈0. 05）. Compared with group B,patients in group C were better in terms of incision length, blood loss, and start time of walk （ P 〈 0. 05 ）. Three days and 6 months after surgery, the patients were reviewed by CT, X-ray, the vertebral anterior height, Cobb angle and sagittal index were significantly recovered （ P 〈 0. 05 ）. Six months after surgery, the index decreased, compared with the postoperative 3 d, but there were no statistical difference （ P 〉 0. 05 ）. There were no significant differences in the three indexes among the three groups at 3 days and 6 months after operation. Compared with the preoperative, postoperative 6 months with Oswestry disability index and visual analogue scale decreased significantly, the differ-ences were statistically significant （ P 〈0. 05）. After 6 months, compared with group A, group B and group C were significantly improved in treatment effect （ P 〈 0. 05 ） , and group C was better than group B （ P 〈 0. 05 ） . There was nosignificant difference in postoperative complications among the three groups （P 〉0. 05）. Conclusions Minimally in-vasiv

关 键 词：QUADRANT通道 Sextant内固定 胸腰椎骨折 手术损伤 

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