摘要
目的对比经皮椎弓根螺钉内固定技术与传统后路切开复位椎弓根螺钉内固定治疗胸腰段椎体骨折的临床疗效。方法 40例胸腰段椎体骨折患者,20例采用经皮椎弓根螺钉内固定技术治疗(微创组),20例采用传统后路切开复位椎弓根螺钉内固定治疗(传统组)。比较两组患者的手术切口长度、手术时间、术中出血量、术后引流量、住院时间、术前及术后椎体前缘高度、后凸Cobb角、术前及术后7天、3个月的疼痛视觉模拟评分(VAS)。结果与传统组相比,微创组的手术切口长度明显缩短(P<0.01),手术时间明显缩短(P<0.05),术中出血量(P<0.05)和术后引流量(P<0.05)明显减少,住院时间明显缩短(P<0.01)。两组患者术前VAS无差异,术后7天及3个月微创组VAS比传统组明显降低(P<0.05)、各组内术后7天及3个月VAS均较术前明显降低(P<0.05)。两组患者间术前、术后伤椎椎体前缘高度、后凸Cobb角度无显著性差异,各组内术前、术后伤椎椎体前缘高度均有明显恢复(P<0.05)、后凸Cobb角度均有明显减小(P<0.05)。结论经皮椎弓根螺钉内固定技术治疗胸腰段椎体骨折疗效确切,同时具有微创、住院时间短、术后疼痛轻等优点。
Objective To compare the clinical outcomes of open versus percutaneous pedicle screw fixation in the treatment of thoraco-lumbar vertebral fracture. Methods Forty patients diagnosed with fracture of thoracolumbar vertebra were involved in this study. Among them,20 were treated with percutaneous pedicle screw fixation（minimally invasive group）,20 were treated with traditional open pedicle screw fixation（tra-ditional group）. Perioperative and postoperative parameters from these patients in the two groups were compared. Results Compared with tradi-tional group,the operation time and hospital stay were shorter（ P ﹤ 0. 05 and P ﹤ 0. 01,respectively）,operative bleeding volume and postopera-tive drainage volume were less in microinvasive group（ P ﹤ 0. 05）. VAS on the postoperative day 7 and at postoperative month 3 in minimally in-vasive group were all lower than those of traditional group（ P ﹤ 0. 05）. There were no difference in the height of vertebral anterior edge,Cobbˋs angles of kyphos preoperative and postoperative between two groups;however,the height of vertebral anterior edge,Cobbˋs angles of kyphos preop-erative and postoperative in each group were improved significantly（ P ﹤ 0. 05）. Conclusion Percutaneous pedicle screw fixation for treatment of thoracolumbar vertebral fracture has advantages of minimal invasion,shorter hospital stay,and less postoperative pain.
出处
《临床和实验医学杂志》
2015年第1期17-20,共4页
Journal of Clinical and Experimental Medicine
基金
北京京煤集团总医院院级课题(编号:2012-09)
