摘要
目的通过对小切口手术显露与传统手术显露完成的胸腰椎前路手术的临床结果作比较,总结小切口胸腰椎前路手术的特点,以改进手术质量。方法采用SynFrame和EndoRing前路手术拉钩系统,经胸膜外腹膜后或腹膜外入路完成胸腰椎前路减压、固定、融合手术(ALIF)19例,其结果和传统前路手术完成的25例作比较。统计分析采用卡方检验和t检验。结果所有手术均顺利完成。失血量小切口组398.42±52.52ml,少于传统组739.60±153.88m(l(P<0.001);切口长度小切口组11.05±1.31cm,小于传统组19.40±1.55cm((P<0.001);术后24小时胃肠道功能恢复小切口组15人/19人,优于传统组2人/25人((P<0.001);VAS评分改善值小切口组3.57±0.76,而传统组2.64±0.99((P<0.001);其余指标比较均无统计学意义(P>0.05)。随访时间6～24个月,平均为(14.50±2.40)个月。患者疼痛消失,植骨全部融合。结论SynFrame/Endoring拉钩完成的胸腰椎小切口微创手术创伤较小,暴露好,出血少,并发症减少,易于掌握,其手术减压和植骨融合达到传统手术的治疗效果。值得选用。
Objective To investigate the effects of minimal incision exposure and traditional anterior approach for thoracolumbar fracture surgery,to find out the characters of minimal incision approach and to improve the operative method. Method 19 cases with thoracolumbar fracture treated with minimal incision approach, using SynFrame＊ （AO Inc.CH） or EndoRing^TM anterior spinal retractor system （Medtronic Inc.USA）, and 25 cases treated with traditional approach from January 2005 to January 2008 in our hospital were analyzed retrospectively. The effects of the two approaches were com- pared. Statistical analysis was conducted with Х^2 and Student t tests. Results All the operations were successful. The average amount of blood loss in the minimal incision approach group was 398.42±52.52ml,significantly less than that （739.60±153.88ml） in traditional approach group （P〈0.001）;The mean incision length in the mini-open approach group was 11.05±1.3 lore,again significantly less than that（19.40±1.55cm） in traditional approach group （P〈0.001） ;The rate of the restorement of bowel function in the minimal incision approach group was 15/19（78.9%）, significantly higher than that （2/25（8%）） in traditional approach group （P〈0.001 ） ;the visual analogue scale（VAS） in the minimal incision approach group was 3.57±0.76, significantly lower than that（2.64±0.99） in the other group （P〈0.001）. No significant difference was found in the rest of the evaluation indexes between two groups（P〉0.05） .All patients were followed up for 6 -24 months （the average is 14.50±2.40 months）. No patient complained pain ever again after surgery. Successful bony fusion was accomplished in all patients. Conclusion Thoracolumbar fracture surgery via anterior approach can be performed with the help of SynFrame or EndoRing^TM system. Compared with traditional approach, it is less invasive, with better exposure, less bleeding, less complication rate, as well as similar effect, and is yet easier to master, Therefore, it is of value for ap- plication.
出处
《生物骨科材料与临床研究》
CAS
2009年第1期15-18,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
小切口
拉钩
胸腰椎骨折
前路融合手术
Minimal incision
Retracter
Thoracolumbar fracture
Anterior spine fusion
