经皮微创椎弓根螺钉内固定治疗胸腰椎骨折的疗效  

Efficacy of percutaneous minimally invasive pedicle screw fixation in treating thoracolumbar vertebral fractures

作　　者：孙佼 欧阳林志[1] 陈栋[1] 陈金[1] 马春艳[1] 孙雪峰[1] 

机构地区：[1]苏州市相城人民医院骨科,江苏省215131

出　　处：《江苏医药》2017年第19期1394-1397,共4页Jiangsu Medical Journal

摘　　要：目的探讨经皮微创椎弓根螺钉内固定治疗胸腰椎骨折的临床疗效。方法 64例胸腰椎骨折患者随机均分为经皮微创椎弓根螺钉内固定(A)组和切开椎弓根螺钉内固定(B)组,比较两组患者切口长度、出血量、住院天数及并发症发生情况,观察术后1周和6个月两组VAS疼痛评分、Oswestry功能障碍指数(ODI)、伤椎椎体前后缘高度比值及Cobb角的改善情况。结果 A组切口长度、出血量、术后下床活动时间、住院天数少于B组(P<0.05)。A组术后1周VAS疼痛评分和ODI改善程度优于B组(P<0.05)。两组患者术后伤椎椎体前后缘高度比值及Cobb角均较术前改善(P<0.05),但组间比较无统计学差异(P>0.05)。术后两组均未出现神经损伤、内固定松动、失效等并发症。结论与切开椎弓根螺钉内固定比较,经皮微创椎弓根螺钉内固定治疗胸腰段椎体骨折具有创伤小和恢复快的优点。Objective To explore the clinical efficacy of percutaneous minimally invasive pedicle screw fixation in the treatment of thoracolumbar vertebral fractures. Methods Sixty-four patients with thoracolumbar vertebral fractures were equally and randomly divided into two groups of A （treated by percutaneous minimally invasive pedicle screw fixation） and B（treated by open pedicle screw fixation）. The incision length, blood loss during operation, length of hospital stay and complication were compared between two groups. The VAS pain score, Oswestry dysfunction index （ODD, the anterior/posterior margin height ratio of the injured vertebra and the improvement of Cobb angle were observed in 1 week and 6 months after operation. Results The incision length, operative blood loss, the time of off-bed and length of hospital stay were less in group A than those in group B （P〈0. 05）. The improvements of VAS pain score and ODI in group A were better than those in group B in 1 week after operation（P〈0. 05）. The anterior/posterior margin height ratio of injured vertebra and Cobb angle after operation in both two groups were improved after surgery than those before （P〈0. 05）, which were not significanly different between two groups （P〈0. 05）. There were no neurological injuries and internal fixation failure in two groups. Conclusion Compared to open pedicle screw fixation, pereutaneous minimally invasive pedicle screw fixation has the advantages of small trauma, quick recovery, safe and reliabity.

关 键 词：胸腰椎骨折 椎弓根螺钉 

分 类 号：R687[医药卫生—骨科学]