经皮微创椎弓根螺钉闭合复位内固定术治疗胸腰椎骨折中的效果  

Clinical study of minimally invasive closed reduction and internal fixation with pedicle screw for thoracolumbar fracture

作　　者：张宗余[1] 胡军 刘怀莹 李亚伟 姜为民[2] 李雪峰[2] 汪恒[2] Zhang Zongyu;Hu Jun;Liu Huaiying;Li Yawei;Jiang Weimin;Li Xuefeng;Wang Heng(Lianyungang TCM Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Lianyungang ,222000,China;First Hospital Affiliated to Suzhou University,Suzhou 215000,China)

机构地区：[1]南京中医药大学连云港附属医院,连云港222000 [2]苏州大学附属第一医院,苏州215000

出　　处：《河南外科学杂志》2019年第5期4-6,共3页Henan Journal of Surgery

摘　　要：目的评估经皮微创椎弓根螺钉闭合复位内固定术治疗胸腰椎骨折的效果。方法选取2015-12—2018-12间南京中医药大学连云港附属医院和苏州大学附属第一医院收治的60例胸腰椎骨折患者,分别应用经皮微创椎弓根螺钉闭合复位内固定术(微创组)和传统开放椎弓根螺钉复位内固定术(开放组)。比较2组手术时间、切口长度、出血量、术后并发症及术前,术后3d、3个月、末次随访的VAS评分、伤椎Cobb角及椎体前缘高度。结果微创组手术时间稍长,但切口长度小,出血量少;开放组出现1例皮下血肿,1例切口浅部感染,经对症治疗后治愈。2组均未发生脊髓神经根损伤、感染等并发症。术后随访6~12个月,平均8个月,2组患者的VAS评分、伤椎Cobb角及椎体前缘高度均明显改善。结论经皮微创椎弓根螺钉复位内固定术可明显缓解胸腰椎骨折患者的腰部疼痛,有效恢复骨折椎体高度;而且具有切口小、出血量少、对组织损伤小及恢复快等优点,是治疗胸腰椎骨折的一种安全可靠的手术方法。但手术人员及患者承受更多的射线辐射。Objective To evaluate the clinical efficacy of minimally invasive percutaneous pedicle screw internal fixation for thoracolumbar fractures.Methods Lianyungang Nanjing University of Chinese Medicine Affiliated Hospital and the First Hospital Affiliated to Suzhou University from 2015-12 to 2018-12 the application of treatment of fracture cases were 30 cases with thoracic and lumbar minimally invasive percutaneous pedicle screw internal fixation technique and traditional open pedicle screw fixation technique,operation of the two groups were compared before and after three days,three months and VAS score of the final follow up,vertebral Cobb angle and vertebral height,operation time,incision length,bleeding volume and postoperative complications.Results all patients were followed up for 6~12 months,average 8 months,the postoperative pain of two groups reduced significantly,postoperative VAS score,vertebral Cobb angle were significantly improved,minimally invasive percutaneous surgery for a longer time,but the length of incision smaller,less bleeding,no nerve root injury,no concurrent infection.1 case of subcutaneous hematoma in traditional open surgery group,1 case of superficial wound infection,after symptomatic treatment cured,no nerve root injury.Conclusion minimally invasive percutaneous pedicle screw fixation technique can significantly alleviate waist pain for thoracolumbar fracture,obvious recovery of vertebral height,small incision,less bleeding,rapid recovery of tissue injuryetc advantages,the treatment of thoracic and lumbar spine in patients is a safe and reliable method of minimally invasive surgery of fracture,but the operation staff and patients·bear more radiation.

关 键 词：经皮椎弓根螺钉 闭合复位内固定 胸腰椎骨折 

分 类 号：R683.2[医药卫生—骨科学]