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首页> 中文期刊> 《临床骨科杂志》 >自制引导通道经皮置入椎弓根螺钉与开放后路短节段内固定治疗胸腰椎骨折的疗效比较

自制引导通道经皮置入椎弓根螺钉与开放后路短节段内固定治疗胸腰椎骨折的疗效比较

         
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摘要

Objective To compare clinical effects between guide chunnel with self-designed assistance method in placement of percutaneous pedicle screws and the open posterior surgery method in placement of ordinary pedicle screws for treatment of thoracolumbar fracture. Methods The clinical date of 52 patients with thoracolumbar factures and no nerve injury were included in this study. They were treated with the posterior percutaneous pedicle screw with self-designed minimally invasive device (26 cases) and the posterior open pedicle screw fixation (26 cases),respec-tively. The two operative methods were compared in terms of operation time,intraoperative X-ray exposure time,the length of the incision,intraoperative bleeding volume,visual analogue scale(VAS) of incision at postoperative 1 d,an-terior height ratio of the injured vertebra,Cobb angles of kyphosis after surgery, loss rate of reduction and complica-tions. The accuracy of pedicle screw placement in two groups was compared. Results All the patients were followed up for 10～18 months. No serious side-effects and complications such iatrogenic nerve root injury,postoperative infec-tion,pedicle screw withdrawal and fracture were observed in both groups. Incison length,intraoperative blood loss, in-cision VAS at postoperative 1 d of the minimally invasive group were also significantly less than those of the open group (P＜0.05). But the operation time and intraoperative X-ray exposure time for the minimally invasive group were longer than the open group(P＜0.05). For the minimally invasive group, these indexes with the anterior height of the compressed vertebrae and Cobb angle improvement were better than those of the open group(P＜0.05). The minimally invasive group about the late loss rate of reduction was significantly lower than that for the open group(P＜0.05). There were no significantly differences of pedicle screw placement accuracy between the two groups(P ＞0.05). Conclusions In the treatment of thoracolumbar fractures, compared with the open posterior surgery,the pos-terior short-segment pedicle screw fixation with self-designed minimally invasive device can lead to less trauma, less bleeding volume, more effective reduction, more reliable fixation and better outcome.%目的 比较应用自制引导通道经皮置入椎弓根螺钉与开放后路切开短节段内固定治疗胸腰椎骨折的临床疗效.方法 将52例无神经损伤的胸腰椎骨折患者分别采用自制引导通道经皮椎弓根螺钉短节段内固定(微创组,26例)和开放后路切开短节段椎弓根螺钉内固定(开放组,26例)治疗.比较两组的手术时间、术中X线透视时间、切口长度、术中出血量、术后1 d切口疼痛VAS评分、术后伤椎前缘高度比值、术后后凸Cobb角及复位丢失率;并比较两组椎弓根螺钉置钉准确性.结果 患者均获得随访,时间10～18个月.两组均未出现医源性神经根损伤、术后感染及椎弓根螺钉退出、断裂等并发症.切口长度、术中出血量、术后1d切口疼痛VAS评分微创组均少于开放组(P＜0.05);但手术时间、术中 X线透视时间均长于开放组(P＜0.05).术后伤椎前缘高度和后凸Cobb角的改善情况微创组优于开放组(P＜0.05),伤椎前缘高度复位丢失率微创组低于开放组(P＜0.05).两组椎弓根螺钉置入的准确性比较差异无统计学意义(P＞0.05).结论 与开放后路切开短节段椎弓根螺钉内固定比较,应用自制引导通道微创器械经皮椎弓根螺钉短节段内固定治疗胸腰椎骨折具有损伤小、出血少、复位效果良好、固定牢固等优点.

著录项

  • 来源
    《临床骨科杂志》 |2018年第3期|266-269273|共5页
  • 作者

    程彬; 史柏娜; 赵敏; 周江军; 肖春林; 付美清; 杨俊; 李建华;

  • 作者单位

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

    解放军第184 医院骨二科(南京军区脊柱外科诊疗中心),江西 鹰潭 335000;

  • 原文格式 PDF
  • 正文语种 chi
  • 中图分类 脊椎骨折;骨骼手术;
  • 关键词

    脊椎骨折; 置钉通道; 椎弓根螺钉; 微创性;

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