摘要
目的比较后路经皮微创与多裂肌间隙入路椎弓根螺钉内固定治疗A1型胸腰段椎体骨折的临床疗效。方法将43例A1型胸腰段椎体骨折患者按手术方式不同分为A组(19例,采用经皮微创椎弓根螺钉内固定)与B组(24例,采用经多裂肌间隙行椎弓根螺钉内固定)。比较两组切口长度、手术时间、透视次数、术中出血量、疼痛VAS评分、伤椎前缘高度百分比、后凸Cobb角等。结果两组患者均随访1年。切口长度和术中出血量A组短(少)于B组(P<0.01),手术时间、透视次数A组长(多)于B组(P<0.001)。伤椎前缘高度百分比和后凸Cobb角术前、术后1周、术后1年两组比较差异均无统计学意义(P>0.05)。VAS评分术后第1天、术后1周A组低于B组(P<0.05),术后1年两组比较差异无统计学意义(P>0.05)。结论经皮微创与多裂肌间隙椎弓根螺钉内固定治疗A1型胸腰段椎体骨折疗效均确切。经皮微创较经多裂肌间隙椎弓根螺钉内固定手术损伤更小、术后早期疼痛程度更轻。
Objective To compare the surgical outcomes between percutaneous minimally invasive pedicle screw fixation and posterior paraspinal muscle space approach pedicle screw fixation for the treatment of type A1 thoracolumbar fracture.Methods According to the surgical methods,43 patients were divided into group A(19 cases were treated with percutaneous minimally invasive pedicle screw fixation)and group B(24 cases were treated with paraspinal muscle space approach pedicle screw fixation).The surgical incision length,operation time,number of fluoroscopy,intraoperative blood loss volume,visual analogue scale(VAS),anterior vertebral height percentage(AVHP)and kyphotic Cobb angle(CA)were compared,respectively.Results All patients were followed up for 12 months.Compared with group B,group A had shorter surgical incision length and less bleeding volume(P<0.01),but the operation time was longer and number of fluoroscopy was more(P<0.001).There were no statistically significant differences in kyphtic CA and AVHP between the two groups at the preoparation,1 week and 1 year after surgery(P>0.05).The VAS at the postoperative 1 d and 1 week were lower in group A than those in group B(P<0.05),but there was no significant difference between the two groups at 1 year after operation(P>0.05).Conclusions The same fixed effection can be achieved by percutaneous minimally invasive pedicle screw and posterior paraspinal muscle space approach pedicle screw fixation.Also,the former has less trauma and less early pain.
作者
韩明远
贺振年
郭剑
史旭超
岑文冲
HAN Ming-yuan;HE Zhen-nian;GUO Jian;SHI Xu-chao;CEN Wen-chong(Dept of Orthopaedics,Beilun District People′s Hospital of Ningbo City,Ningbo, Zhejiang 315800,China)
出处
《临床骨科杂志》
2020年第2期161-164,共4页
Journal of Clinical Orthopaedics
基金
浙江省医药卫生科技计划项目(编号:2015ZHB005)
浙江省宁波市第二批县级医学龙头学科项目。
关键词
胸腰椎骨折
经皮微创手术
伤椎固定
短节段固定
A1型
thoracolumbar fractures
percutaneous minimally invasive surgery
injuried vertebra fixation
short segment pedicle instrumentation
type A1
