摘要
目的探讨后路短节段经皮经伤椎椎弓根螺钉内固定治疗单节段胸腰段骨折的临床疗效。方法对2014年1月至2016年9月的78例单节段胸腰段骨折病人进行回顾性分析,其中行微创手术的38例纳入微创组,行开放手术的40例纳入开放组。比较两组病人的术中出血量、手术时间、住院时间;比较两组病人术后3 d、6个月、1年的椎体前缘高度比、矢状面后凸Cobb角;比较两组病人术后1周、3个月、1年的疼痛视觉模拟量表(visual analogue scale,VAS)评分、腰椎Oswestry功能障碍指数(Oswestry disability index,ODI)。结果 78例病人伤口均一期愈合,未见明显并发症。微创组的术中出血量、住院时间均显著低于开放组;但微创组的手术时间明显长于开放组,上述差异均有统计学意义(P均<0.05)。两组病人术后的伤椎前缘高度比和矢状面后凸Cobb角均较术前显著改善;但两组间手术前后各时间点的伤椎前缘高度比和矢状面后凸Cobb角比较,差异均无统计学意义(P均>0.05)。微创组术后1周、3个月的VAS评分和ODI小于开放组,差异均有统计学意义(P均<0.05)。结论后路短节段经皮经伤椎椎弓根螺钉内固定创伤小、出血少,术后疼痛缓解和功能恢复快,住院时间短,在恢复椎体高度、纠正后凸畸形、维持脊柱稳定性和伤椎高度方面与开放手术相当,值得临床推广。
Objective To investigate the clinical effect of percutaneous short-segment posterior pedicle screw through the fractured vertebra for the treatment of thoracolumbar fractures.Methods From January 2014 to September 2016,the clinical data of 78 cases of single segmental thoracolumbar fractures were retrospectively reviewed,including 38 cases in minimally invasive percutaneous group and 40 cases in open group.The blood loss,operative time,drainage volume,length of hospital stay,the injured anterior vertebral body height,Cobb angle,visual analogue scale(VAS)and Oswestry disability index(ODI)between the two groups were compared.Results All the 78 patients were healed without complications.The blood loss and drainage volume were significantly less,length of hospital stay was significantly shorter,and the operative time was significantly longer in the minimally invasive percutaneous group than in the open group(P<0.05 for all).The injured anterior vertebral body height and Cobb angle in two groups were obviously increased,but there was no statistically significant difference between the two groups.The VAS and ODI in the minimally invasive percutaneous group at the 1st week and 3rd month after operation were significantly reduced as compared with those in the open group.Conclusion The internal fixation with percutaneous short-segment posterior pedicle screw through the fractured vertebra has the advantages of milder operation trauma,less blood loss,quicker relief of postoperative pain and functional recovery,and shorter hospital stay than the open operation.
作者
贾吉光
刘江涛
徐俊昌
庄正陵
邹峰
廖晓龙
JIA Ji-guang;LIU Jiang-tao;XU Jun-chang;ZHUANG Zheng-ling;ZOU Feng;LIAO Xiao-long(Department of Orthopaedics,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang 441000,China)
出处
《骨科》
CAS
2018年第4期268-273,共6页
ORTHOPAEDICS
关键词
胸椎
腰椎
脊柱骨折
骨折固定术
内
Thoracic vertebrae
Lumbar vertebrae
Spinal fractures
Fracture fixation,internal
