临床骨科杂志2018，Vol.21Issue(3)：266-269,273,5.DOI:10.3969/j.issn.1008-0287.2018.03.004
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
Comparison effect of minimally invasive with the guide chunnel with self-designed assistance and open posterior short-segment pedicle screws internal fixation in the treatment of thoraco-lumbar vertebral fractures
摘要
Abstract
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.关键词
脊椎骨折/置钉通道/椎弓根螺钉/微创性Key words
spinal fracture/nailing channel/pedicle screw/minimally invasive分类
医药卫生引用本文复制引用
程彬,史柏娜,赵敏,周江军,肖春林,付美清,杨俊,李建华..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[J].临床骨科杂志,2018,21(3):266-269,273,5.基金项目
南京军区医学科技创新课题重点项目(编号:15ZD023) （编号:15ZD023）
