新型与常规经皮椎弓根钉内固定治疗无神经损伤胸腰椎骨折的比较  

Comparison of two different percutaneous pedicle screw fixation for thoracolumbar fractures without neurological deficit

作　　者：昌震[1] 郝定均[1] 胡雄科 杨明[1] 尹新华[1] 王晓东[1] 赵勤鹏[1] CHANG Zhen;HAO Ding-jun;HU Xiong-ke;YANG Ming;YIN Xin-hua;WANG Xiao-dong;ZHAO Qin-peng(Department of Spine Surgery, Honghui Hospital Affiliated to Xi＇an Jiaotong University, Xi＇an, Shannxi 710054, China)

机构地区：[1]西安交通大学附属红会医院脊柱外科,陕西西安710054

出　　处：《中国骨与关节损伤杂志》2018年第5期463-465,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的比较常规经皮椎弓根钉和新型强力复位经皮椎弓根钉内固定治疗无神经损伤胸腰椎骨折的临床疗效。方法回顾性分析自2014-09—2016-06诊治的66例无神经损伤胸腰椎骨折,采用常规经皮椎弓根钉内固定治疗32例(常规组),采用新型强力复位经皮椎弓根钉内固定治疗34例(新型组)。比较2组手术时间、术中出血量、住院时间,术后3个月时腰痛VAS评分,以及术后3个月、末次随访时伤椎Cobb角、伤椎前缘高度比值。结果 66例均获得随访,随访时间平均14.6(12~27)个月。常规组与新型组手术时间、术中出血量、住院时间、术后3个月腰痛VAS评分差异无统计学意义(P>0.05)。新型组术后3个月、末次随访时伤椎Cobb角、伤椎前缘高度比值明显优于常规组,差异有统计学意义(P<0.05)。结论常规与新型经皮椎弓根钉内固定治疗无神经损伤胸腰椎骨折均可以取得良好的疗效,但新型强力复位经皮椎弓根钉内固定在恢复伤椎高度及改善后凸畸形方面更具有优势。Objective To compare the clinical effect of the conventional percutaneous pedicle screw and the new strong reduction percutaneous pedicle screw fixation in the treatment of thoracolumbar fracture without nerve injury. Methods Sixty-six patients with thoracolumbar fractures without nerve injury between Sept. 2014 and Jun. 2016 were recruited in this study. Thirty two cases were treated with a conventional pedicle screw system（conventional group） while 34 cases with the new strong reduction pedicle screw system developed by our hospital（new group）. The operative time, intraoperative blood loss and hospital stay were compared between the 2 groups. The VAS score of low back pain at 3 months after operation, and the ratio of injured vertebral Cobb angle to the anterior edge height of injured vertebrae at 3 months and the last follow-up period were compared. Results All 66 cases were followed up, and the average follow-up time was 14.6（12-27） months. There were no significant differences between the 2 groups in operation time, intraoperative bleeding, time of hospitalization, and VAS score of low back pain after 3 months of operation（P〉 0.05）. The ratio of the Cobb angle of the injured vertebra and the height of the anterior margin of the injured vertebra at the 3 month and last follow-up after the operation of the new group was obviously superior to that of the conventional group, the difference was statistically significant(P〈 0.05）. Conclusion Conventional and new percutaneous pedicle screw fixation for thoracolumbar fractures without nerve injury can achieve good results, but new strong reduction percutaneous pedicle screw fixation has more advantages in restoring the height of injured vertebrae and improving kyphosis.

关 键 词：无神经损伤胸腰椎骨折 强力复位椎弓根钉 内固定 微创 经皮 

分 类 号：R687.3[医药卫生—骨科学]