摘要
目的探讨不同方式置入椎弓根螺钉治疗胸腰段骨折的疗效与生物相容性。方法选择75例脊柱胸腰段骨折的病人,随机分为三组,其中A组采用椎旁肌间隙入路,B组采用经皮微创入路,C组采用传统后正中入路。比较三组修复术前、术后即刻与末次随访时椎体前缘高度和后凸角矫正效果。观察术中出血量、手术时间、术后总引流量、术后卧床时间与住院时间。采用视觉模拟评分法(VAS)评估术前、术后2周与随访1年时病人的疼痛情况,并随访观察病人发生的不良事件等。结果三组病人术后即刻与随访1年时椎体前缘高度显著高于手术前,后凸角显著低于手术前(P<0.05),但三组之间相互比较均未发现统计学差异(P>0.05)。A组和B组术中出血量、手术时间,术后总引流量、术后卧床时间与住院时间均显著低于C组(P<0.05)。B组术后引流量和术后卧床时间显著低于A组(P<0.05)。三组病人术后2周和随访1年时VAS评分均显著低于术前(P<0.05),但是,三组之间的比较无统计学差异(P>0.05)。随访12个月未发现明显不良事件。结论经椎旁肌间隙入路与经皮微创入路椎弓根螺钉内固定治疗胸腰段骨折的临床效果相当,均能体现创伤小、出血少、恢复快、矫形效果好的特点。
Objective To explore the effect and biocompatibility of different ways for placement of pedicle screws in treatment of thoraco-lumbar fractures. Methods Seventy - five patients with thoracolumbar fractures were randomly divided into three groups according to repair approaches. Patients in group A were treated with paraspinal muscle gap approach, patients in group B were treated with minimally invasive percutaneous approach, and patients in group C were administered by conventional posterior approach. The results for correction of anterior vertebral height, kyphotic angle before and after the operation were compared. The bleeding volume, operating time, total amount of postoperative drainage, postoperative bed rest and hospital stay were observed. Visual analogue scale （VAS） was used to evaluate pain status before and after 2 weeks and in follow - up period for 1 year, and the adverse events in patients were observed in follow - up period for 1 year. Results The anterior vertebral height of patients in these three groups was significantly higher than that of pre - operation and kyphosis had been improved in 1 year after operation, but the difference was not statistically significant among these three groups. The bleeding volume, operating time, total volume of postoperative drainage, bed rest time and hospital stay were significantly lower in group A and B than those of group C. The drainage volume and bed rest time in group B were significantly lower than those of group A. The VAS scores of these three groups in preoperative period were significantly lower than those at postoperative period and in one - year follow - up period, but the difference was not statistically significant among these three groups.No significant adverse events had been found during the follow - up period of 12 months. Conclusion The clinical results of transparaminal approach and minimally invasive percutaneous pedicle screw fixation for treatment of patients with thoracolumbar vertebral fractures are equivalent, and they can reflect t
出处
《临床和实验医学杂志》
2017年第11期1130-1133,共4页
Journal of Clinical and Experimental Medicine
关键词
胸腰段骨折
椎弓根螺钉
入路
微创
疗效
生物相容性
Thoracolumbar fracture
Pedicle screw
Approach
Minimally invasive
Curative effect
Biocompatibility
