经皮自旋转撑开椎弓根螺钉内固定系统与开放椎弓根螺钉内固定治疗胸腰椎骨折的对比研究  

Comparative study on percutaneous rotation-self oriented distraction trauma fixation system and open pedicle screw fixation in the treatment of thoracolumbar fractures

作　　者：柴旭斌[1] 周英杰[1] 黄勇[1] 

机构地区：[1]河南省洛阳正骨医院/河南省骨科医院脊柱外二科,河南洛阳471002

出　　处：《中国骨与关节外科》2017年第2期109-112,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:随着微创脊柱外科技术的发展,经皮椎弓根螺钉技术逐步被应用于胸腰椎骨折的治疗。目的:对比研究经皮自旋转撑开椎弓根螺钉内固定系统(RTS)与常规后路开放椎弓根螺钉内固定治疗胸腰椎骨折的临床效果。方法法:回顾性分析2014年3月至2016年2月因单纯胸腰椎骨折在我科行手术治疗的患者65例,根据治疗方案分为采用RTS系统的微创组37例,采用常规后路开放椎弓根螺钉内固定的开放组28例。比较两组不同手术方式的手术时间、出血量、术后卧床时间、住院天数等情况,在术前、术后1 d、术后1年比较患者椎体前缘高度、Cobb角、视觉疼痛模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分情况。结果:所有患者均顺利完成手术。与开放组相比,微创组术中出血量少,患者卧床时间、住院天数时间短,但两者手术时间无明显区别。两组术后1 d、术后1年的椎体前缘高度、cobb角与治疗前比较均有明显改善(P<0.05),但组间比较无统计学差异。两组术后1 d的VAS评分较治疗前明显改善(P<0.05),但组间比较无统计学差异。术后1年的VAS评分微创组较开放组低(P<0.05)。两组术后1 d的ODI评分较术前有明显降低(P<0.05),且RTS组下降更加明显,与开放组比较有统计学差异(P<0.05);术后1年,RTS组患者基本无疼痛症状,开放组患者仍存在一定的疼痛情况(P<0.05)。结论:RTS系统治疗胸腰椎骨折具有手术出血少、创伤小、康复周期短等优势,且治疗效果与开放手术基本相同,远期疗效好,具有微创性。Background：With the development of minimally invasive spinal technique, percutaneous pedicle screw fixation has been widely used for the treatment of thoracolumbar vertebral fractures. Objective：To compare the clinical outcomes between rotation-self oriented distraction trauma fixation system （RTS） and traditional posterior open pedicle screw fixation in the treatment of thoracolumbar vertebral fractures. Methods：A retrospective study was conducted in 65 patients with thora-columbar fractures treated from March 2014 to February 2016 in our hospital. According to the treatment programs, the patients were divided into minimally invasive group （RTS system treatment） and open group （conventional posterior open surgery）. The operation time, bleeding volume, postoperative bedridden time and hospital stay were compared between two groups. The height of anterior vertebral border, Cobb angle, VAS score and ODI score were measured preoperatively and on day 1 and 1 year postoperatively. Results：All the operations were successfully completed. Compared with the open group, the minimally invasive group had less blood loss, postoperative bedridden time and hospital stay. But there was no significant difference in operation time between the two groups. The height of anterior vertebral border and Cobb angle were significantly improved after surgery in both groups （P〈0.05）, but there was no significant difference in the two parameters between the two groups. The VAS score was significantly improved in both groups on day 1 postoperatively （P〈0.05）, but there was no significant difference between the two groups. At 1 year after surgery, the VAS score of the minimally invasive group was lower than that of the open group （P〈0.05）. The ODI score was significantly decreased in both groups on day 1 postoperatively （P〈0.05）, and the ODI score of the minimally invasive group was significantly lower than that of the open group （P〈0.05）. At 1 year after surgery, the pain disappeared in the mi

关 键 词：外科手术 微创性 内固定器 脊柱骨折 

分 类 号：R687.3[医药卫生—骨科学]