新型凹形体位垫经皮椎弓根螺钉固定治疗胸腰椎骨折  

A novel concave posture mat for percutaneous pedicle screw fixation of thoracolumbar fractures

作　　者：黄晓枫[1] 李果[1] 何跃 王崇文 顾祖超[1] 江敏[1] 柳波[1] HUANG Xiao-feng;LI Guo;HE Yue;WANG Chong-wen;GU Zu-chao;JIANG Min;LIU Bo(Chengdu First Peopled Hospital,Chengdu 610004,China)

机构地区：[1]成都市第一人民医院,四川成都610004

出　　处：《中国矫形外科杂志》2021年第20期1829-1833,共5页Orthopedic Journal of China

摘　　要：[目的]探讨新型凹形脊柱体位垫经皮椎弓根螺钉治疗胸腰椎骨折的临床效果。[方法]2016年1月-2019年1月,120例胸腰椎骨折患者纳入本研究,均行体位复位经皮椎弓根钉内固定。其中60例采用新型凹形脊柱体位垫(新型垫组),60例采用普通脊柱体位(普通垫组)。比较两组围手术期、随访和影像资料。[结果]两组患者均顺利完成手术。全麻仰卧位时,两组间中心静脉压(central venous pressure,CVP)、腹内压(intraabdominal pressure,IAP)和气道压力(pressure of air way,PAW)的差异无统计学意义(P>0.05);俯卧位10min时,新型垫组的CVP和IAP显著小于普通垫组(P<0.05);俯卧位30 min时,两组间CVP、IAP和PAW的差异无统计学意义(P>0.05)。新型垫组手术时间、术中失血量、器械撑开次数和透视次数均显著优于普通垫组(P<0.05)。两组患者均获12个月以上随访,随术后时间推移,两组患者VAS和0DI评分均显著下降(P<0.05)。相应时间点,两组VAS和0DI评分的差异均无统计学意义(P>0.05)。影像方面,体位摆放后新型垫组的椎体前缘高度和局部Cobb角均优于普通垫组(P<0.05);术后即刻和取内固定时椎体前缘相对高度和局部Cobb角差异均无统计学意义(P>0.05)。[结论]新型凹形脊柱体位垫经皮椎弓根螺钉固定胸腰椎骨折可显著提高手术安全性与效率。[Objective]To explore the clinical outcomes of a novel concave spine posture mat for percutaneous pedicle screw in the treatment of thoracolumbar fractures.[Methods]From January 2016 to January 2019,a total of 120 patients with thoracolumbar fractures were included in this study,and received postural reduction and percutaneous pedicle screw internal fixation.Among them,60 patients had operation performed by using the new concave spine position mat,while the remaining 60 patients were by using the conventional spine position mat.The perioperative period,follow-up and imaging data were compared between the two groups.[Results]The patients in both groups were successfully operated on.The CVP,IAP and PAW in the supine position under general anesthesia were not statistically different between the two groups(P>0.05);while 10 minutes in the prone position the CVP and IAP of the new mat group were significantly lower than those of the conventional mat group(P<0.05);and became of no significant difference again between the two groups 30 minutes in the prone position(P>0.05).The new mat group was significantly better than the conventional mat group in terms of operation time,intraoperative blood loss,frequency of device extensions and fluoroscopy times(P<0.05).Patients in the two groups were followed up for more than 12 months.As time went after operation,the VAS score and ODI scores of the two groups decreased significantly(P<0.05).At the corresponding time point,there was no statistically significant differences in VAS and ODI scores between the two groups(P>0.05).In terms of imaging evaluation,the relative anterior vertebral height and the local Cobb angle in the new mat group were significantly better than those of the conventional mat group(P<0.05);although the aforesaid 2 parameters were not statistically different immediately after surgery and at the time after internal fixation removed(P>0.05).[Conclusion]The new concave spine posture mat does significantly improve the safety and efficiency of percutaneous pedicle

关 键 词：胸腰椎骨折 新型体位垫 经皮椎弓根螺钉 

分 类 号：R683.2[医药卫生—骨科学]