经皮终板复位螺钉技术在A3型胸腰椎骨折经皮内固定术的应用  

Application effects of percutaneous endplate reduction screw technique in percutaneous fixation of type A3 thoracolumbar fractures

作　　者：钱亮 王自鸿 徐伟 彭明学 QIAN Liang;WANG Zi-hong;XU Wei;PENG Ming-xue(Department of Orthopaedics,Huairou Hospital of Beijing,Beijing 101400,China)

机构地区：[1]北京怀柔医院骨科,北京101400

出　　处：《蚌埠医学院学报》2022年第1期71-74,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨经皮终板复位螺钉技术在A3型胸腰椎骨折经皮内固定术的运用效果。方法:纳入66例A3型胸腰椎骨折病人,均伴终板严重塌陷,随机均分为2组。对照组采用单纯经皮短节段固定,观察组采用经皮终板复位螺钉技术联合短节段固定,随访2~4年,比较2组围术期手术指标及随访并发症情况,术前、术后7 d、末次随访视觉模拟(VAS)疼痛评分、伤椎中部高度比、伤椎前缘高度比以及后凸Cobb角。结果:2组手术时间、术中出血量、住院时间以及术后并发症发生率差异均无统计学意义(P>0.05);与术前相比,2组术后7 d、末次随访后凸Cobb角、VAS评分均降低,伤椎中部高度比、伤椎前缘高度比均升高(P<0.05~P<0.01);术前各指标2组差异均无统计学意义(P>0.05),术后7 d观察组伤椎中部高度高于对照组(P<0.01),观察组末次随访后凸Cobb角较低(P<0.01)。结论:经皮终板复位螺钉技术在伴终板严重塌陷的A3型胸腰椎骨折经皮内固定术中能够有效进行终板中央部塌陷复位,减少术后后凸Cobb角及伤椎中部高度丢失。Objective:To explore the application effects of percutaneous endplate reduction screw technique in percutaneous internal fixation of type A3 thoracolumbar fractures.Methods:Sixty-six patients with type A3 thoracolumbar fractures complicated with severe endplate collapse were randomly divided into the control group and observation group.The control group was treated with the percutaneous short-segment fixation,and the observation group was treated with percutaneous endplate reduction screw technique combined with short-segment fixation.Two groups were followed up for 2-4 years,the perioperative surgical indicators and following up complications,visual analogue scale(VAS)pain score,ratio of height in the middle and anterior edge of injured vertebra,and Cobb angle of kyphosis before operation,after 7 days of operation and at the last following up were compared between two groups.Results:There was no statistical significance in the operation time,intraoperative blood loss,length of hospital stays and incidence rate of postoperative complications between two groups(P>0.05).Compared with before operation,the kyphotic Cobb angle and VAS scores in two groups decreased,and the height ratios of the middle and anterior edge of injured vertebra increased after 7 days of operation and at the last following up(P<0.05 to P<0.01).There was no statistical significance in preoperative indexes between two groups(P>0.05).The height of middle of injured vertebra in the observation group after 7 days of operation was higher(P<0.01),and the kyphotic Cobb Angle was lower in the observation group at the last following up(P<0.01).Conclusions:The percutaneous endplate reduction screw technique can effectively reduce the central endplate collapse in the percutaneous fixation of type A3 thoracolumbar fractures complicated with severe endplate collapse,and reduce the loss of postoperative kyphosis Cobb angle and height of the middle injured vertebra.

关 键 词：胸腰椎骨折 经皮终板复位螺钉技术 经皮内固定 

分 类 号：R683[医药卫生—骨科学]