经皮微创与开放型椎弓根内固定治疗胸腰椎骨折价值比较  

Comparison of the value of percutaneous minimally invasive and open pedicle internal fixation in the treatment of thoracolumbar fractures

作　　者：刘涛[1] 方宣城 李浩[1] Liu Tao;Fang Xuan—cheng;Li Hao(Department of Spinal Surgery,Anqing First People's Hospital,Anhui Medical University,Anqing 246003,China)

机构地区：[1]安徽医科大学安庆第一人民医院脊柱外科,安庆246003

出　　处：《湖南师范大学学报（医学版）》2022年第2期87-90,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:比较经皮微创与开放型椎弓根内固定治疗胸腰椎骨折的临床效果.方法:选取2019年1月~2020年12月期间我院收治的60例胸腰椎骨折患者为研究对象,根据手术方法不同分经皮微创组、开放手术组,每组人数30例.比较两组患者切口长度、治疗时间、围手术期出血量、疼痛度指标、椎体角度恢复情况.结果:微创组切口长度63.5±1.2cm明显短于开放组的110.5±4.2cm;两组手术时间无明显差异,围手术期出血量微创组低于开放手术组;术前及术后六个月两组的VAS评分,在术后1周及术后1个月微创组VAS评分显著低于开放手术组;在椎体角度恢复方面,微创组与开放组术前后凸Cobb's角分别为14.5±5.1°、14.6±5.0°,术后4.1±1.2°,4.2±1.3°;治疗后与治疗前两组均有明显统计学差异;椎体前缘高度变化微创组与开放组术前60.2±8.9%、60.9±8.5%;术后92.4±9.4%、92.1±8.7%,治疗后与治疗前两组均有明显统计学差异.结论:经皮微创椎弓根螺钉内固定术作为胸腰椎骨折的微创手术方法,具有切口小、治疗时间短、出血量少及恢复速度快等优势,可明显减少患者疼痛度,未来具有推广和研究价值.Objective To compare the clinical ejffect of percutaneous minimally invasive and open pedicle internal fixation in the treatment of thoracolumbar fractures.Methods A total of 60 patients with thoracolumbar fractures were treated in our hospital from January 2019 to December 2020 as research objects.According to different surgical methods,they were divided into percutaneous minimally invasive group and open surgery group,with 30 cases in each group.The incision length,treatment time,perioperative blood loss,pain index,and vertebral body angle recovery were compared between the two groups.Results The incision length of the minimally invasive group was 63.5±1.2 cm lower than that of the control group,which was 110.5±4.2 cm,and the difference was statistically significant.The perioperative blood loss in the minimally invasive group was lower than the open surgery group.The VAS scores of the two groups were no significant difference.The VAS scores of the group were significantly lower than those of the open surgery group.In terms of vertebral body angle recovery,the Cobb*s angles of the minimally invasive group and the open group were 14.5±5.10,14.6±5.0o after operation,4.1±1.2°,4.2±1.30 after treatment;the two groups after treatment and before treatment There were significant statistical differences;the anterior verte-bral height changes in the minimally invasive group and the open group were 60.2±8.9%and 60.9±8.5%before operation;92.4±9.4%and 92.1±8.7%after There were significant differences between the two groups before treatment.Conclusion Percutaneous minimally invasive pedicle screw fixation,as a minimally invasive surgical method for thoracolumbar fractures,has the advantages of small incision,short treatment time and less blood loss.It can significantly reduce the pain of patients and has the value of promotion and research in the future.

关 键 词：经皮微创 椎弓根螺钉 内固定 胸腰椎骨折 

分 类 号：R683[医药卫生—骨科学]