摘要
目的比较经皮微创自撑开椎弓根螺钉内固定与传统肝放椎弓根螺钉内固定治疗胸腰椎骨折的临床疗效。方法自2012年1月至2012年12月收治尤神经系统损伤的胸腰椎骨折患者46例，分别采川经皮微创自撑开椎弓根螺钉内固定（微创组，24例）和传统肝放椎弓根螺钉内㈨定（开放组，22例）治疗，闪组患者术前一般资料比较差异均无统计学意义（P〉0．05），具有可比性。记录并比较两组患者围手术期相关指标、随访时影像学指标及Oswesiry功能障碍指数（ODI）。结果所订患者平均随访12个月（10-14个月）。与开放组比较，微创组的手术切口小、术中出血量少、术后引流量少、术后Id切口视觉模拟评分低，但手术时间和术中X线透视时问长，以下指标两组间比较靛婷均有统计学意义（P〈0．05）。未次随访时所有患者的伤椎前缘高度、伤椎前缘高度百分比、后凸cobb角均较术前改澎。苊异有统计学意义（P〈0．05）。术次随访时微创组的伤椎前缘高度恢复、伤椎前缘幽度百分比、后凸cobb角的改善程度、ODl与开放组比较差异均无统计学意义（P〉0．05）。结论与传统开放椎弓根螺钉内同定比较，经皮自撑丌椎弓根螺钉内固定治疗胸腰椎骨折安全可靠、创伤小、出血少、恢复快。
Objective To compare the midterm clinical outcomes of minimally invasive pereutanenus self-dilating pediele screw-rod system and conventional open pedicle screw-rod system in the treatment of thoracolmnbar fratqures. Methods Enrolled in this research were 46 patients who had received surgery in our department from January 2012 to March 2013 fnr thoraeolnmbar fracture without neurological symptoms. Of them, 24 were Ireated with minimally invasive percutaneous fixation by self-dilating pedicle screw-rod system and 22 with open fixation by conventional pedicle screw-rod system. There were no significant differences between the 2 groups in general data preoperation （ P 〉 0.05） . The＋ 2 groups were compared in terms of perioperative indexes, fnltow-np radiographic indexes and Oswestry disability index （ODI）. Results All patients were fidlowe〈l up for 10 to 14 months （average, 12 months） . Compared with the open group, the minimally invasive group had smaller incisions, less intraoperative blood loss, less postoperative drainage, lower visual analogue scale （VAS） scores for incision one day postoperative, but hmger operation time and intraoperative radiation exposure, with statistical signifieances in all the above differences （ P 〈 0.05） . Compared with prenperation, significant imprnvements were observed at the last fl^llow-up in all the patients regarding cobb angle, sagittal index and anterior height of the fi＋aetured vertebral body （ P 〈 0.05）, but there were no signific＋ant differences between the 2 groups regarding cobb angle, sagittal index and anterior height of the fractured verlebral body at the last follow-up （ P 〉 0.05）. There was no significant difference between the 2 groups either regarding ODI at the last folluw-up （ P 〉 0. 05） . Conclusion Minimally invasive per- cutaneous self-dilating pediele screw-rod system is an effective and safe trealment of thoracohnnbar fraetures, because it may lead tu more limited invasion, less bleeding, and quicker reeovey than the conventional pediele serew-rnd system.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2014年第3期208-211,共4页
Chinese Journal of Orthopaedic Trauma
关键词
胸椎
腰椎
骨折
外科手术
微创性
Thoracic vertebrae
Lumbar vertebrae
Fracture, bone
Surgical procedures minimally invasive
