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经皮椎弓根螺钉治疗胸腰椎骨折的临床研究
作者:黄杰聪 谢俊杰 曾志远 
单位:福建医科大学附属泉州市第一医院 福建 泉州 362000 
关键词:微创 椎弓根 胸腰椎 
分类号:R 683.2
出版年,卷(期):页码:2020,37(2):133-135
摘要:

 摘要:目的 观察经皮椎弓根螺钉内固定微创治疗胸腰椎骨折的疗效。方法 选取2015年1月~2018年6月我院骨科收治的单节段胸腰椎骨折患者56例,行胸腰椎CT检查均提示骨块突入椎管内。根据治疗方法不同分为跨伤椎固定组26例和经伤椎固定组30例,比较两组的术中出血量、手术时间及住院时间、手术前、后VAS评分、ODI指数及影像学指标。结果 两组手术时间比较差异有统计学意义(P<0.05);两组术后VAS评分、ODI指数及影像学指标与术前比较差异具有统计学意义(P<0.05);术后6个月跨伤椎固定组的伤椎椎体前缘高度及矢状位后凸Cobb角显著低于术前,差异有统计学意义(P<0.05),而经伤椎固定组无显著差异。术后两组间椎管内侵占率比较无显著差异。结论 两种微创经皮椎弓根内固定对单节段骨折块突入椎管内的胸腰椎骨折均具有良好的效果,能有效复位椎管内骨折块,经伤椎固定有利于脊柱后凸畸形的矫正及远期矫正效果的维持。

 Abstract:Objective To observe the curative effect of percutaneous pedicle screw fixation for thoracolumbar fracture. Methods A total of 56 selected patients with mono-segmental thoracolumbar fracture with bone mass protruded into the spinal canal showed by CT were treated in the department of orthopaedics of our hospital from January 2015 to June 2018, and divided into 26 cases of internal fixations across injured vertebrae group and 30 cases of through injured vertebrae group according to different treatment methods. The intraoperative blood loss, time of operation and hospital stay, VAS scores before and after surgery, ODI index and imaging indicators were compared between two groups. Results The difference in operation time between the two groups was statistically significant(P<0.05); the postoperative VAS scores ,ODI indexes and various imaging indexes between the two groups were statistically significant compared with the preoperative value(P<0.05). In 6 months after the operation, the anterior height of the injured vertebra and the Cobb Angle of sagittal kyphoid in internal fixations across injured vertebrae group were significantly lower than those in pre-operation, and the differences were statistically significant(P<0.05).  But there were no significantly differences in internal fixations through injured vertebrae group. There was no significant difference in the rate of canal encroachment between the two groups after surgery. Conclusion The two minimally invasive percutaneous pedicle internal fixations have good effects on mono-segmental thoracolumbar fractures with bone mass protruded into the spinal canal, and can effectively reduce the fractures in the spinal canal, and internal fixations through injured vertebrae is conducive to spinal protruding deformity correction and maintain long-term correction effect.

基金项目:
作者简介:
参考文献:

 [1] Choi UY,Park JY,Kim KH,et al. Unilateral versus bilateral percutaneous

pedicle screw fixation in minimally invasive transforaminal lumbar
interbody fusion[J]. Neurosurgical Focus,2013,35(2):E11.
[2] 郑光新,赵晓鸥,刘广林,等. Oswestry功能障碍指数评定腰痛患者的可信性[J]. 中国脊柱脊髓杂志,2002,12(1):13-15.
[3] 常锐,王德春.三种伤椎置钉固定胸腰段爆裂骨折的疗效对比[J]. 中国矫形外科志,2017,25(6):521-526.
[4] 许财元,张涛,高中玉,等.短节段椎弓根钉内固定治疗胸腰椎骨折-经伤椎与跨伤椎的临床疗效比较[J]. 天津医科大学学报,2016,22(1):58-61.
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