摘要
目的观察伴神经功能损伤胸腰椎骨折应用后路微创小切口减压联合经皮椎弓根螺钉复位内固定术与传统开放减压复位内固定术的治疗效果。方法选取108例伴神经功能损伤胸腰椎骨折患者,按术式不同分为两组各54例,对照组行传统开放减压复位内固定术,观察组行后路微创小切口减压联合经皮椎弓根螺钉复位内固定术,比较两组手术指标、脊柱结构、神经功能恢复情况。结果观察组切口长度、出血量、引流量、术后日本骨科协会评估治疗(JOA)评分、住院时间均显著优于对照组(P<0. 01);两组矢状面Cobb角、椎体前缘高度、矢状位指数、伤椎楔变角较术前显著改善(P<0. 01),两组神经功能恢复分级、并发症比较差异无统计学意义(P>0. 05)。结论两种手术治疗伴神经功能损伤胸腰椎骨折的效果相当,但后路微创小切口减压联合经皮椎弓根螺钉复位内固定术的创伤少、疼痛轻、出血量少,且恢复快。
Objective To observe the effect of minimally invasive posterior decompression combined with percutaneous pedicle screw reduction vs traditional open decompression reduction and internal fixation in treatment of thoracolumbar fractures complicated by neurologic impairment. Methods The clinical data of 108 patients with thoracolumbar fractures complicated by neurologic impairment who were diagnosed and treated from December 2016 to December 2017 were selected and divided into 2 groups according to the different types of operation performed, with 54 patients in each group. The control group received traditional open decompression reduction and internal fixation, and the observation group received minimally invasive posterior decompression combined with percutaneous pedicle screw reduction. The surgical indexes, spinal structure and nerve function recovery were compared between the two groups. Results The length of incision, bleeding volume, drainage volume, postoperative JOA score and length of hospital stay in the observation group were respectively （7.46±2.64） cm, （271.56±25.56） ml, （74.52±13.62） ml, （20.14±5.11）, （ 19.15±6.24）d, all were better than those of control group （P〈0.01）. The Cobb angel of the sagittal plane [ （2.41± 1.52 ） ovs （ 2.25 ± 1.41 ）°], the anterior vertebral height [ （ 83.24 ± 16.25 ） % vs （ 83.26 ± 18.11 ） % ], the sagittal index [ （ 7.21 ± 5.33 ）°] vs （ 7.38± 4.25 ）°] and the affected vertebral body angle [ （ 4.07± 3.14 ） ovs （ 4.06 ± 2.41 ）°] in the observation group and the control group were both improved after treatment （ P〈0. 01 ）. There was no significant difference in the recovery of neurological function and the incidence of complications between the two groups （ P〉0.05 ）. Conclusions Effect of minimally invasive posterior decompression combined with percutaneous pedicle screw reduction and traditional open decompression reduction and internal fixation is similar on treatment of thoraeolumbar fractures complicated by neurologie impairment, but the former incurs less incision and bleeding, produces less pain and shortens the time for recovery.
作者
陈磊
CHEN Lei(No.2 Department of Orthopedics,the First Affiliated Hospital of Shihezi University Medical College,Shihezi 832000,Xinjiang,China)
出处
《中国老年学杂志》
CAS
北大核心
2018年第19期4672-4675,共4页
Chinese Journal of Gerontology
基金
国家自然科学基金资助项目(81160224)
2017年石河子大学研究生案例库建设项目(2017Y-AL14)
关键词
胸腰椎骨折
神经损伤
后路微创小切口减压
经皮椎弓根螺钉复位内固定
传统开放减压复位内固定
Thoracolumbar fractures
Nerve injury
Posterior minimally invasive mini-incision decompression
Pereutaneous pedicle screw reduction and internal fixation
Traditional open decompression and reduction and internal fixation
