经皮微创椎弓根螺钉内固定治疗胸腰椎AO-A1型骨折  

Percutaneous minimally invasive pedicle screw internal fixation in treatment of type AO-A1 thoracolumbar fractures

作　　者：袁景 王建峰 杨平 王志军 甄平 YUAN Jing;WANG Jian-feng;YANG Ping;WANG Zhi-jun;ZHEN Ping(SectionⅡ,Dept of Orthopaedics,the People′s Hospital of Qingyang City,Qingyang,Gansu 745000,China;General Army Orthopaedics Center,the 940th Hospital of the Joint Logistic Support Force of the CPLA,Lanzhou,Gansu 730050,China)

机构地区：[1]庆阳市人民医院骨二科,甘肃庆阳745000 [2]中国人民解放军第九四〇医院全军骨科中心,甘肃兰州730050

出　　处：《临床骨科杂志》2020年第3期345-347,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨经皮微创椎弓根螺钉内固定治疗胸腰椎AO-A1型骨折的临床效果。方法对45例胸腰椎AO-A1型患者采用经皮微创椎弓根螺钉内固定。记录手术时间、术中出血量、骨折愈合时间、术后并发症,比较术前与术后6个月疼痛VAS评分和Cobb角。末次随访时采用腰椎功能MacNab标准评定疗效。结果手术时间35~80(60.4±15.6)min,术中出血量40~120(85.0±36.5)ml。患者均获得随访,时间12~18个月。伤口均一期愈合,无感染、神经根或脊髓损伤等并发症发生,未出现椎弓根螺钉断裂及松动现象。4例患者出现腰背部轻微疼痛,口服药物后缓解。VAS评分、Cobb角术后6个月与术前比较差异均有统计学意义(P<0.05)。末次随访时,根据腰椎功能MacNab标准评定疗效:优34例,良7例,可3例,差1例,优良率91.11%。结论经皮微创椎弓根螺钉内固定治疗胸腰椎AO-A1型骨折损伤小、手术时间短、术后恢复快、并发症少,临床疗效满意。Objective To investigate clinical effects of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar fractures with type AO-A1.Methods The 45 patients with type AO-A1 thoracolumbar vertebral compression fracture were treated with percutaneous minimally invasive pedicle screw fixation.The operation time,intraoperative blood loss volume,fracture healing time,postoperative complications were recorded,VAS and Cobb angles before and after 6 months surgery were compared,and the lumbar function was assessed with MacNab criterion at the last follow-up.Results The operation time was 35~80(60.4±15.6)min,the intraoperative bleeding volume was 40~120(85.0±36.5)ml.All patients were followed up for 12~18 months.There was no infection,nerve root or spinal cord injury,no pedicle screw fracture and loosening occurred.Four patients had slight back pain,which was relieved after taking medicine.At the last follow-up,the curative effect was evaluated according to MacNab criterion of lumbar spine function,the result was excellent in 34 cases,good in 7,fair in 3,poor in 1,the excellent and good rate was 91.11%.Conclusions Percutaneous minimally invasive pedicle screw fixation is effective in the treatment of type AO-A1 thoracolumbar compression fractures,which has the advantages of less trauma,short operation time,less bleeding volme,fewer complications and satisfactory effect.

关 键 词：胸腰椎骨折 微创 经皮椎弓根置钉 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]