摘要
背景:脊柱微创外科的迅速发展,对于脊柱骨折尤其是胸腰椎骨折的治疗在器械和理念上近年来都不断迅速更新,减少了手术创伤、缩短康复时间、提高了治疗满意度。目的:对比微创经皮与开放伤椎置钉在无神经损伤胸腰椎骨折治疗中的应用效果。方法:回顾性分析解放军东部战区海军医院2015年1月至2018年12月收治的52例无神经损伤胸腰椎骨折患者的病历资料,根据置钉技术分为2组,观察组24例行微创经皮伤椎置入椎弓根螺钉内固定治疗,对照组28例行开放伤椎置入椎弓根螺钉内固定治疗。对比两组患者的围术期指标(手术时间、术中出血量、术中透视次数、术后住院日、切口愈合率),并随访患者术后腰背痛目测类比评分、椎体前缘高度百分比及矢状面后凸Cobb角。结果与结论:①观察组的围术期指标中手术时间、术中透视次数多于对照组(P<0.05),但是术中出血量、术后住院日和切口愈合率均优于对照组(P<0.05);②所有患者均完成12个月以上随访,观察组术后3 d、1个月、3个月、6个月、12个月的腰背痛目测类比评分均优于对照组(P<0.05),而椎体前缘高度百分比、矢状面后凸Cobb角相比两组差异无显著性意义(P>0.05);③结果提示,微创经皮伤椎置钉治疗无神经损伤的胸腰椎骨折可减少手术创伤,虽然在透视次数、手术时间方面有所增加,但是临床疗效肯定。
BACKGROUND:The rapid development of spine minimally invasive surgery,the treatment of spinal fractures,especially thoracolumbar fractures,has been rapidly updated in recent years in equipment and concepts,reducing surgical trauma,shortening recovery time,and improving treatment satisfaction.OBJECTIVE:To analyze the therapeutic effect of percutaneous pedicle screw placement and open wound placement in the treatment of thoracolumbar fractures without nerve injury.METHODS:A retrospective analysis of 52 patients with thoracolumbar fractures without nerve injury who were admitted to Naval Hospital of Eastern Theater Command from January 2015 to December 2018.According to nail placement technology,the patients were divided into two groups.The 24 patients in the observation group received percutaneous pedicle screw placement combined with injured vertebrae nail placement technology.The 28 patients in the control group received open injured vertebrae nail placement.Perioperative indicators(operation time,intraoperative blood loss,intraoperative fluoroscopy,postoperative hospital stay,and incision healing rate)were compared between the two groups.Postoperative low back pain visual analogous scale score,anterior vertebral height percentage,and sagittal kyphotic Cobb angle were analyzed during follow-up.RESULTS AND CONCLUSION:(1)The operation time and the number of intraoperative fluoroscopy were more in the observation group than those of the control group(P<0.05),but the blood loss,postoperative hospital stay and incision healing rate were better in the observation group than those of the control group(P<0.05).(2)All patients completed a follow-up for more than 12 months.The visual analogous scale scores of low back pain at 3 days,1,3,6,and 12 months after surgery in the observation group were better than those in the control group(P<0.05).There was no significant difference in the anterior body height percentage and the sagittal kyphosis Cobb angle between the two groups(P>0.05).(3)The results suggest that the minimally invasive percutaneous vertebral nail placement technique reduces surgical trauma,although there are differences in fluoroscopy and operation time.However,the clinical effect is affirmative.
作者
邹守平
卢道云
叶力
Zou Shouping;Lu Daoyun;Ye Li(Department of Orthopedics,Naval Hospital of Eastern Theater Command,Zhoushan 316000,Zhejiang Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第24期3865-3869,共5页
Chinese Journal of Tissue Engineering Research
关键词
胸腰椎骨折
微创
经皮
椎弓根螺钉
内固定
伤椎置钉
随访
thoracolumbar vertebral fractures
minimally invasive
percutaneous
pedicle screw
internal fixation
vertebral nail placement
follow-up
