摘要
背景:胸腰段椎体骨折行开放手术治疗时,大多数学者认为需要行伤椎固定,但在微创手术治疗中,是否需要固定伤椎,目前还不明确。目的:探讨经皮微创自撑开钉治疗胸腰段椎体骨折中伤椎固定的临床意义。方法:自2013年2月至2014年2月西安交通大学医学院附属红会医院收治无神经系统损伤的胸腰段椎体骨折患者36例,按固定方法分为经伤椎固定组和跨伤椎固定组,各18例,均采取经皮自撑开钉微创治疗,其中经伤椎固定组固定伤椎及伤椎上、下椎体,跨伤椎固定组固定伤椎上、下椎体)。结果与结论:与经伤椎固定组相比,跨伤椎固定组手术切口小、术中出血量少、手术时间和术中X射线透视时间短(P<0.05)。内固定1年后,2组患者伤椎前缘高度、伤椎前缘高度百分比、后凸cobb角均较内固定前改善(P<0.05),但2组伤椎前缘高度、伤椎前缘高度百分比、后凸cobb角和Oswestry功能障碍指数差异均无显著性意义(P>0.05)。说明跨伤椎固定与经伤椎固定的临床效果接近,但术中跨伤椎固定更具优势。因此经皮微创自撑开钉治疗胸腰段椎体骨折行伤椎固定意义不大。
BACKGROUND： Most scholars believed that injured vertebral body needs to be fixed in the open surgery of thoracolumbar vertebral fractures; however, it is unclear whether injured vertebra needs to be fixed in the minimally invasive surgery. OBJECTIVE： To investigate the clinical outcomes of minimally invasive percutaneous self-dilating pedicle in repair of injured vertebral fixation in thoracolumbar vertebral fractures. METHODS： Totally 36 patients with thoracolumbar vertebral fractures without nervous system injury who received treatment in Honghui Hospital, Xi＇an Jiaotong University Health Science Center from February 2013to February 2014 were enrolled and divided into injured vertebral fixation and cross-injured vertebral fixation groups（n=18/group）. Patients in these two groups were all subjected to minimally invasive percutaneous self-dilating pedicle treatment. The injured vertebral body, upper, and lower vertebrae of injured vertebral body were fixed in injured vertebral fixation group, and the upper and lower vertebrae of injured vertebral body was fixed in cross-injured vertebral fixation group. RESULTS AND CONCLUSION： Compared with the injured vertebral fixation group, the cross-injured vertebral fixation group had smaller incisions, less intraoperative blood loss, less operation tine and intraoperative X-ray fluoroscopy time（P〈0.05）. After one year of internal fixation, the anterior vertebral height, anterior vertebral height percentage and kyphotic Cobb angle of patients in these two groups improved compared with those before internal fixation（P〈0.05）, but there were no significant differences in anterior vertebral height percentage, kyphotic Cobb angle and Oswestry disability index between these two groups（P〈0.05）. These results demonstrate that anterior vertebral height cross-injured vertebral fixation has the similar clinical effect with injured vertebral fixation, but cross-injured vertebral fixation had more advantage in the operation. Therefore, there is little significance of conducting injured vertebral fixation in the surgery of minimally invasive percutaneous self-dilating pedicle in repair of thoracolumbar vertebral fractures.
出处
《中国组织工程研究》
CAS
北大核心
2016年第9期1249-1254,共6页
Chinese Journal of Tissue Engineering Research
