摘要
目的探讨经皮单节段经伤椎固定治疗胸腰椎爆裂骨折（AO分型A3．1和A3．2）的可行性、安全性和疗效。方法回顾分析2010年3-12月收治的胸腰椎爆裂骨折（AO分型A3．1和A3．2）患者24例，采用经皮单节段椎弓根螺钉固定治疗。计算手术时间、出血量、术前术后视觉模拟评分（visualanaloguescale，VAS）、伤椎椎体前缘高度与正常椎体比值和伤椎后凸Cobb角。结果经皮单节段固定手术时间（904-25）min，术中出血量（20±10）ml。伤椎前缘高度与正常椎体比值术前为56．5±10．1，术后1周为92．3±12．2，术后1年随访时为90．2±11．1；伤椎后凸Cobb角术前为（16．5±5．2）°，术后1周为（7．3±2．4）°，术后1年随访时为（7．9±3．5）°；VAS术前为（7．0±1．2）分，术后1周为（1．2±0．7）分，术后1年随访时为（1．1±0．5）分。术后1周伤椎椎体前缘高度比值较术前明显增高（P〈0．05），1年随访时伤椎椎体前缘高度比值较术前也明显增高（P〈0．05），术后1周伤椎体前缘高度比值与术后1年相比，差异无统计学意义（P〉0．05）。伤椎后凸Cobb角术后1周及1年随访时较术前明显减小（P〈0．05）。术后1周及1年随访时VAS较术前均有明显改善。结论后路经皮经伤椎单节段固定治疗胸腰椎爆裂骨折（AO分型A3．1和A3．2）安全、有效，但不适用于椎体压缩严重的胸腰椎爆裂骨折。
Objective To investigate the feasibility, safety and therapeutic effects of minimally invasive percutaneous mono-segment pedicle instrumentation in treating thoracolumbar burst fractures （ AO classification： A 3.1 and A 3.2）. Methods Twenty-four inpatients with thoracolumbar burst frac- tures （ AO classification ： A 3.1 and A 3.2） treated with percutaneous mono-segment pedicle instrumen- tation from March 2010 to December 2010 were retrospectively studied. The operation time, blood loss, pre-and post-operative visual analogue scale （VAS） , ratio of anterior height between compressed vertebral body and normal vertebral body and vertebral kyphotie Cobb＇ s angle were evaluated. Results The op- eration lasted for （90 ± 25 ） minutes, with intraoperative blood loss of （20 ± 10） ml. The rate of anterior body height rose from pre-operative （56.5 ± 10.1 ） to （92.3 ± 12.2） one week post-operatively and to （90.2 ± 11.1 ）at the follow-up one year later. The vertebral kyphotic Cobb＇ s angle was pre-operative （16.5 ± 5.2）° , which was reduced to （7.3 ± 2.4） ° at one week after surgery and （7.9 ± 3.5 ）° at the follow-up one year later respectively. The VAS scored （ 7. 0±1.2 ） points before surgery, （ 1.2 ± 0.7 ） points at one week after surgery and （ 1. 1 ±0. 5 ） points at the follow-up one year later. The ratio of anterior body height at one week after surgery and at the follow-up one year later were both obviously high- er than that before surgery （ P 〈 0.05 ）, but the ratio one week postoperatively showed no significant difference in comparison with that one year postoperatively （ P 〉 0.05 ）. The kyphotic Cobb＇ s angle hadsignificant decrease at one week after surgery and at the follow-up one year later, as compared with that before operation （P 〈 0.05）. Also, the VAS score showed marked improvement at one week after surgery and at the follow-up one year later. Conclusions Minimally invasive percutaneous mono-segmental pedicle i
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2012年第6期496-499,共4页
Chinese Journal of Trauma
基金
国家自然科学基金资助项目（30970718）
上海市科委“科技创新行动计划”重点资助项目（08411952500）
上海市医学领军人才资助项目（LJ10017）
关键词
脊柱骨折
骨折固定术
内
外科手术
微创性
Spinal fractures
Fracture fixation, internal
Surgical procedures, minimallyinvasive
