经Wiltse入路联合伤椎置钉技术椎弓根螺钉内固定治疗胸腰椎骨折的效果  

Effect of Wiltse approach combined with injuried vertebral screw placement and pedicle screw internal fixation in the treatment of thoracolumbar fractures

作　　者：蔡志刚[1] 穆臣会[1] 郭氧[1] CAI Zhigang;MU Chenhui;GUO Yang(Department of Orthopaedics, the First Affiliated Hospital of Xiamen University, Xiamen 361022, China)

机构地区：[1]厦门大学附属第一医院骨科

出　　处：《中国现代医生》2019年第22期65-67,71,共4页China Modern Doctor

摘　　要：目的探讨经Wiltse入路联合伤椎置钉技术椎弓根螺钉内固定治疗胸腰椎骨折的疗效。方法选择2016年1月~2018年1月在我院治疗的72例胸腰椎骨折患者进行随机分组,对照组与实验组各36例,对照组患者应用后正中入路治疗,实验组给予经Wiltse入路联合伤椎置钉技术椎弓根螺钉内固定,观察比较两组手术指标、VAS评分、椎体前缘高度、Cobb角差异。结果实验组术中出血量(120.53±15.69)mL、术后引流量(69.95±17.86)mL、VAS评分(2.43±0.93)分均较对照组明显下降(P<0.05),两组手术时间相比较无统计学意义(P>0.05);术前、术后2周两组患者椎体前缘高度、Cobb角水平无显著差异(P>0.05)、术后1年两组患者椎体前缘高度、Cobb角水平有显著差异(P<0.05)。结论针对胸腰椎骨折患者经Wiltse入路联合伤椎置钉技术椎弓根螺钉内固定治疗效果显著,创伤小、安全性高,有效缓解疼痛,促进椎体高度恢复,值得推广应用。Objective To evaluate the efficacy of Wiltse approach combined with injuried vertebral screw placement and pedicle screw internal fixation in the treatment of thoracolumbar fractures. Methods 72 patients with thoracolumbar fractures treated in our hospital from January 2016 to January 2018 were randomly divided into the control group and the experimental group, with 36 patients in each group. The control group was treated with the posterior median approach. The experimental group was treated with Wiltse approach combined with injuried vertebral screw placement and pedicle screw internal fixation. The difference in surgical index, VAS score, vertebral front body height, Cobb angle between the two groups was observed and compared. Results The intraoperative blood loss(120.53±15.69)mL, postoperative drainage(69.95±17.86)mL, and VAS score(2.43±0.93) were significantly lower in the experimental group than those in the control group(P<0.05). There was no statistically significant difference in the operation time between two groups(P>0.05). There was no significant difference in vertebral height and Cobb angle between the two groups before and 2 weeks after operation(P>0.05). There was a significant difference in vertebral front body height and Cobb angle between two groups one year after operation(P<0.05). Conclusion For patients with thoracolumbar fractures, Wiltse approach combined with injuried vertebral screw placement and pedicle screw internal fixation is effective, with less trauma and high safety, which effectively relieves pain and promotes vertebral height recovery. It is worthy of popularization and application.

关 键 词：Wiltse入路 伤椎置钉技术 椎弓根螺钉内固定 胸腰椎骨折 

分 类 号：R687.3[医药卫生—骨科学]