| 短节段经皮微创与传统椎弓根螺钉内固定治疗伴后方韧带复合体损伤的胸腰椎骨折的比较 |
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Received:September 18, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 何海潮 |
HE Hai-chao |
东阳市人民医院骨科, 浙江 东阳 322100 |
Department of Orthopaedics, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
hehaichao2001@126.com |
| 吕晓强 |
LYU Xiao-qiang |
东阳市人民医院骨科, 浙江 东阳 322100 |
Department of Orthopaedics, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
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| 张永进 |
ZHANG Yong-jin |
东阳市人民医院骨科, 浙江 东阳 322100 |
Department of Orthopaedics, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
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| 期刊信息：《中国骨伤》2016年29卷，第4期，第329-334页 |
| DOI：10.3969/j.issn.1003-0034.2016.04.009 |
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目的:探讨短节段经皮微创与常规切开椎弓根螺钉内固定治疗伴后方韧带复合体损伤的胸腰椎骨折的临床疗效.
方法:对2013年2月至2014年8月收治的伴后方韧带复合体损伤的32例不稳定胸腰椎骨折进行回顾性分析,均为单节段椎体骨折,其中男13例,女19例;年龄25~55岁.根据治疗方法不同分为两组,15例采用经皮微创椎弓根螺钉固定(微创组),17例采用常规切开椎弓根螺钉内固定(传统组).观察两组患者的手术时间、术中出血量、术后引流量、带支具离床时间及术后24 h肌酸激酶数值;比较两组患者术后VAS评分、Oswestry功能障碍指数;测量并计算椎体恢复高度、后凸Cobb角.
结果:所有患者获得随访,时间8~14个月,平均12.3个月.微创组的手术时间、术中出血量、术后引流量、带支具离床时间、术后24 h肌酸激酶数值均少于传统组.微创组术后1~3 d的VAS评分小于传统组,术后3个月ODI指数优于传统组.两组术后的椎体恢复高度和后凸Cobb角差异无统计学意义.
结论:经皮微创椎弓根螺钉内固定技术符合微创原则,在治疗单节段伴有后方韧带复合体损伤的胸腰椎骨折是安全的,有良好的临床疗效. |
| [关键词]:脊柱骨折 胸椎 腰椎 骨折固定术,内 外科手术,微创性 病例对照研究 |
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| Comparative study of short segment percutaneous minimally invasive and conventional pedicle screw fixation for the treatment of thoracolumbar fractures with posterior ligament injury |
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Abstract:
Objective:To investigate the effect of short segment percutaneous minimally invasive and conventional pedicle screw fixation in treating thoracolumbar fractures with posterior ligament injury.
Methods:A retrospective analysis from February 2013 to August 2014,a retrospective analysis received 32 patients with unstable thoracolumbar fractures with posterior ligament complex injury were performed,all cases were single vertebral fracture including 13 males and 19 females,aged from 25 to 55 years old. According to the different treatment methods,the patients were divided into two groups,15 cases were treated with minimally invasive percutaneous pedicle screw fixation(minimally invasive group),17 cases were treated with conventional pedicle screw fixation (traditional group). The operation time,intraoperative bleeding volume,postoperative drainage,ambulation time wearing a brace,creatine kinase value after 24 hours between two groups were observed;postoperative VAS score,Oswestry disability index between two groups were compared,the recovery of vertebral height,improvement of Cobb's angle were measured and accounted.
Results:All patients were followed up for 8 to 14 months (averaged 12.3 months). The operation time,intraoperative bleeding volume and postoperative drainage,postoperative ambulation time wearing a brace,and creatine kinase values postoperative 24 hours in minimally invasive group were less than those of the traditional group,the difference was statistically significant. The VAS score postoperative 1 to 3 days of minimally invasive group was less than that of the traditional group,the ODI index of minimally invasive group at 3 months after operation was better than that of the traditional group,the difference was statistically significant. There were no significant differences in the restore vertebral body height and Cobb's angle improvement between two groups.
Conclusion: Minimally invasive percutaneous pedicle screw fixation with minimally invasive technology principle is safe method,and has a good clinical effect for the treatment of single segment thoracolumbar fractures with posterior ligament injury. |
| KEYWORDS:Spinal fractures Thoracic vertebrae Lumbar vertebrae Fracture fixation,internal Surgical procedures,minimally invasive Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 何海潮,吕晓强,张永进.短节段经皮微创与传统椎弓根螺钉内固定治疗伴后方韧带复合体损伤的胸腰椎骨折的比较[J].中国骨伤,2016,29(4):329~334 |
| 英文格式: | HE Hai-chao,LYU Xiao-qiang,ZHANG Yong-jin.Comparative study of short segment percutaneous minimally invasive and conventional pedicle screw fixation for the treatment of thoracolumbar fractures with posterior ligament injury[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):329~334 |
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