摘要
目的观察自行设计的双支点体外撑开器在经皮椎弓根螺钉复位治疗胸腰椎骨折中的应用价值。方法对2014年1月至2015年5月收治的41例无神经损伤症状的胸腰椎骨折患者资料进行回顾性分析，患者均采用微创经皮复位椎弓根螺钉内固定手术治疗，其中22例（双支点组）采用自行设计的新型双支点体外撑开器复位骨折，19例（单支点组）采用常用单支点体外撑开器复位骨折。通过比较两组患者手术前、后椎体前、中、后缘高度、伤椎后凸cobb角、矫正率等影像学指标，评价该撑开器的治疗效果及应用价值。结果所有患者术后随访6～18个月，平均12．3个月，均未出现医源性神经根损伤及术后感染、内置物断裂、折弯现象等术中及术后并发症。所有患者术后伤椎前缘、中部、后缘高度比、后凸cobb角均较术前改善，差异有统计学意义（P〈0．05）。双支点组术后伤椎前缘、中部高度比、后凸cobb角及矫正率均优于单支点组，差异有统计学意义（P〈0．05），但椎体后缘高度恢复两组间比较差异无统计学意义（P〉0．05）。结论与常用单支点撑开复位器比较，应用自行设计的双支点撑开复位器经皮微创椎弓根螺钉复位内固定治疗胸腰椎骨折更具有满意的骨折撑开复位效果。
Objective To evaluate the clinical results of self-designed double-pivot extracorporeal reduction device in internal fixation with percutaneous pedicle screws for thoracolumbar fractures. Methods From January 2014 to May 2015, a total of 41 patients with thoracolumbar fracture without neurological symptoms underwent minimally invasive fixation with percutaneous pedicle screws. Of them, 22 were treated with our self-designed double-pivot extracorporeal reduction device and the other 20 with common single-pivot extracorporeal reduction device. The 2 groups were compared in terms of pre- and postoperative kyphotic an- gles, correction rates and anterior, middle and posterior heights of injured vertebrae to evaluate the therapeutic effects of the self-designed double-pivot extracorporeal reduction device. Results The patients were fol- lowed up for 6 to 18 months （average, 12. 3 months）. No iatrogenic impairment of nerve root, postoperative infection, or implant failure happened. Compared with preoperation, significant improvements were observed in all the patients regarding cobb＇ s angle, anterior, middle and posterior heights of the fractured vertebral body （ P 〈 0. 05 ）. Compared with the single-pivot group, the double-pivot group were significantly superior in the kyphotic angle, correction rate, and anterior and middle heights of the injured vertebrae （ P 〈 0. 05）, but there was no significant difference between the 2 groups in the recovery of posterior height of the fractured ver- tebral body（ P 〉 0. 05）. Conclusion Compared with the single-pivot reduction device, the self-designed double-pivot reduction device may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2016年第12期1075-1081,共7页
Chinese Journal of Orthopaedic Trauma
基金
贵阳市科技计划项目（[20141001]20）
关键词
胸椎
腰椎
骨折固定术
内
骨钉
外科手术
微创性
Thoracic vertebrae
Lumber vertebrae
Fracture fixation, internal
Bone nails
Surgical procedures, minimally invasive
