纯A⁃P技术经皮椎弓根螺钉内固定术治疗胸腰椎压缩性骨折的临床疗效  

Clinical efficacy of percutaneous pedicle screw fixation with absolutely anteroposterior technique in treatment of thoracolumbar compression fractures

作　　者：张世磊 闫铭 丁子毅 罗卓荆[1] ZHANG Shi-lei;YAN Ming;DING Zi-yi;LUO Zhuo-jing(Department of Orthopaedics,Xijing Hospital of the Air Force Medical University,Xi'an 710032,China)

机构地区：[1]中国人民解放军空军军医大学西京医院骨科,西安710032

出　　处：《骨科》2020年第5期392-397,共6页ORTHOPAEDICS

基　　金：国家自然科学基金青年项目(81301581)。

摘　　要：目的探讨纯A-P技术经皮椎弓根螺钉内固定手术治疗胸腰椎压缩性骨折的临床疗效。方法回顾性分析2013年1月至2016年1月我院采用经皮椎弓根螺钉内固定术治疗胸腰椎压缩性骨折的病人85例,根据手术方式不同分为两组:观察组45例,采用纯A-P技术经皮单平面椎弓根螺钉内固定术;对照组40例,采用传统开放椎弓根螺钉内固定术。收集并比较两组病人的围手术期相关指标、术后功能恢复情况、影像学指标及置钉准确率。结果病人平均随访时间为14个月。观察组的手术时间、术中出血量、切口长度、术后住院时间均明显低于对照组(P均<0.05);两组的置钉准确率、透视次数比较,差异均无统计学意义(P均>0.05)。两组术后的矢状面后凸Cobb's角、Oswestry功能障碍指数(Oswestry disability index, ODI)、疼痛视觉模拟量表(visual analogue scale, VAS)评分均较术前明显降低(P均<0.05),伤椎椎体前缘高度、伤椎椎体后缘高度均较术前明显升高(P均<0.05),但两组间术后指标比较,差异均无统计学意义(P均>0.05)。结论纯A-P技术经皮椎弓根螺钉内固定术治疗胸腰椎压缩性骨折具有创伤小、出血少、术后功能恢复快等优点,建议在大多数医院推广。Objective To investigate the clinical efficacy of percutaneous pedicle screw fixation with absolutely anteroposterior(A⁃P)technique in the treatment of thoracolumbar compression fractures.Methods A retrospective analysis was conducted on 85 patients with thoracolumbar compression fractures treated with percutaneous pedicle screw fixation in our hospital during January 2013 to January 2016.These patients were divided into two groups according to different methods of operation:45 cases in observation group,given percutaneous pedicle screw fixation with absolutely A⁃P technique;40 cases in control group,undergoing traditional pedicle screw fixation.Peri⁃operative related indexes,postoperative functional recovery,imaging indexes as well as pedicle screw placement accuracy were collected to make a comprehensive comparison of these two groups.Results The average follow⁃up time of patients was 14 months.The incision length,intraoperative blood loss,operation time and postoperative hospital stay in the observation group were significantly reduced as compared with those in the control group(P<0.05).There was no statistically significant difference in fluoroscopy times and pedicle screw placement accuracy between two groups(P>0.05).Additionally,the VAS scores,ODI scores and Cobb’s angle of sagittal kyphosis in the two groups were significantly reduced,and the height of the anterior and posterior edge of the injured vertebral body was significantly increased as compared with those before operation(P<0.05).There was no statistically significant difference between two groups in terms of postoperative indexes(P>0.05).Conclusion Percutaneous pedicle screw fixation with absolutely A⁃P technique in the treatment of thoracolumbar compression fractures has the merits of less trauma,less bleeding and quicker recovery of postoperative function.Consequently,it is highly recommended that this technique can be popularized in most hospitals.

关 键 词：纯A⁃P技术 经皮椎弓根螺钉 胸腰椎压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]