微创经皮椎弓根螺钉内固定与开放椎弓根螺钉内固定治疗胸腰椎骨折的效果比较
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摘要
目的:比较微创经皮椎弓根螺钉内固定与开放椎弓根螺钉内固定治疗胸腰椎骨折的效果。方法:将笔者所在医院2016年12月-2018年12月收治的60例胸腰椎骨折患者作为研究对象,按照随机数字表法分为对照组与观察组,各30例。观察组应用微创经皮椎弓根螺钉内固定术治疗,对照组应用开放椎弓根螺钉内固定术治疗。观察并记录两组手术指标,术后伤椎前缘高度、后凸Cobb角及矢状位指数。结果:观察组手术时间、住院时间、切口长度均短于对照组,术中出血量与术后引流量均少于对照组,差异均有统计学意义(P<0.05)。观察组术后伤椎前缘高度、后凸Cobb角及矢状位指数改善情况均优于对照组,差异均有统计学意义(P<0.05)。结论:微创经皮椎弓根螺钉内固定术可缩短手术及住院时间,减小切口长度,减少术中出血量与术后引流量,效果确切,值得在临床中借鉴。
Objective:To compare the effect of minimally invasive percutaneous pedicle screw internal fixation and open pedicle screw internal fixation in the treatment of thoracolumbar fractures.Method:60 patients with thoracolumbar fractures admitted to our hospital from December 2016 to December 2018 were selected as the subjects of study,and 30 patients in each group.The observation group were treated with minimally invasive percutaneous pedicle screw internal fixation,and the control group were treated with open pedicle screw internal fixation.The operative indexes of the two groups were observed and recorded,and the height of the anterior edge of the injured vertebra,Cobb angle and sagittal index were compared.Result:The operation time,hospital stay and incision length in the observation group were shorter than those of the control group,and the intraoperative blood loss,postoperative drainage volume in the observation group were less than those of the control group,the differences were statistically significant(P<0.05).The improvement of the height of the anterior edge of the injured vertebra,Cobb angle and sagittal index in the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Minimally invasive percutaneous pedicle screw internal fixation can shorten the operation time and hospital stay and reduce incision length,reduce intraoperative blood loss and postoperative drainage volume,and has definite curative effect.It is worth learning in clinical practice.
Objective:To compare the effect of minimally invasive percutaneous pedicle screw internal fixation and open pedicle screw internal fixation in the treatment of thoracolumbar fractures.Method:60 patients with thoracolumbar fractures admitted to our hospital from December 2016 to December 2018 were selected as the subjects of study,and 30 patients in each group.The observation group were treated with minimally invasive percutaneous pedicle screw internal fixation,and the control group were treated with open pedicle screw internal fixation.The operative indexes of the two groups were observed and recorded,and the height of the anterior edge of the injured vertebra,Cobb angle and sagittal index were compared.Result:The operation time,hospital stay and incision length in the observation group were shorter than those of the control group,and the intraoperative blood loss,postoperative drainage volume in the observation group were less than those of the control group,the differences were statistically significant(P<0.05).The improvement of the height of the anterior edge of the injured vertebra,Cobb angle and sagittal index in the observation group were better than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Minimally invasive percutaneous pedicle screw internal fixation can shorten the operation time and hospital stay and reduce incision length,reduce intraoperative blood loss and postoperative drainage volume,and has definite curative effect.It is worth learning in clinical practice.
引文
[1]王丙超,徐韬,甫拉提·买买提,等.新型胸腰椎骨折损伤AO分型系统的可信度和可重复性研究[J].中国脊柱脊髓杂志,2016,26(7):602-608.
[2]陈晓陇,尚平,温月凤,等.椎旁肌间隙入路与传统后正中入路在胸腰椎后路手术中的应用比较[J].中国脊柱脊髓杂志,2012,22(10):925-930.
[3]侯煜,卜宏建,杨帆,等.比较不同方式置入椎弓根钉内固定修复胸腰椎爆裂骨折的生物相容性[J].中国组织工程研究,2016,20(9):1234-1241.
[4]柏文昆,张大海,胡红耘.微创椎弓根螺钉内固定术治疗胸腰椎骨折[J].中国基层医药,2014,21(15):2274-2275.
[5]屈小鹏,康凯,刘志斌,等.后路微创小切口减压联合经皮椎弓根螺钉复位内固定术治疗胸腰椎骨折71例[J].陕西医学杂志,2017,46(8):997-998,1001.
[6]顾勇杰,赵刘军,于亮,等.后路短节段伤椎经皮椎弓根螺钉内固定治疗A3型和A4型胸腰段骨折[J].中国脊柱脊髓杂志,2016,26(5):395-400.
[7]Wiltse L L,Spencer C W.New uses and refinements of the paraspinal approach to the lumbar spine[J].Spine,1988,13(6):696-706.
[8]王洋,武汉,张子言,等.腰椎椎旁肌间隙至棘突正中线距离的MRI测量及意义[J].中国脊柱脊髓杂志,2013,23(4):316-319.
[9]Krüger A,Rammler K,Ziring E,et al.Percutaneous minimally invasive instrumentation for traumatic thoracic and lumbar fractures:a prospective analysis[J].Acta Orthop Belg,2012,78(3):376-381.
[10]林子丰,王万明,魏梅洋.椎旁肌间隙入路和传统后正中入路治疗胸腰椎骨折的前瞻性研究[J].创伤外科杂志,2013,15(6):526-530.
[11]吴继彬,郭开今,袁锋,等.经椎旁肌入路结合伤椎固定治疗胸腰段椎体骨折[J].中国矫形外科杂志,2016,24(8):697-701.
[12]何升华,马笃军,孙志涛,等.MAST Quadrant通道下椎旁肌间隙入路经伤椎椎弓根植骨治疗胸腰椎爆裂骨折[J].中国骨伤,2015,28(1):17-20.
[2]陈晓陇,尚平,温月凤,等.椎旁肌间隙入路与传统后正中入路在胸腰椎后路手术中的应用比较[J].中国脊柱脊髓杂志,2012,22(10):925-930.
[3]侯煜,卜宏建,杨帆,等.比较不同方式置入椎弓根钉内固定修复胸腰椎爆裂骨折的生物相容性[J].中国组织工程研究,2016,20(9):1234-1241.
[4]柏文昆,张大海,胡红耘.微创椎弓根螺钉内固定术治疗胸腰椎骨折[J].中国基层医药,2014,21(15):2274-2275.
[5]屈小鹏,康凯,刘志斌,等.后路微创小切口减压联合经皮椎弓根螺钉复位内固定术治疗胸腰椎骨折71例[J].陕西医学杂志,2017,46(8):997-998,1001.
[6]顾勇杰,赵刘军,于亮,等.后路短节段伤椎经皮椎弓根螺钉内固定治疗A3型和A4型胸腰段骨折[J].中国脊柱脊髓杂志,2016,26(5):395-400.
[7]Wiltse L L,Spencer C W.New uses and refinements of the paraspinal approach to the lumbar spine[J].Spine,1988,13(6):696-706.
[8]王洋,武汉,张子言,等.腰椎椎旁肌间隙至棘突正中线距离的MRI测量及意义[J].中国脊柱脊髓杂志,2013,23(4):316-319.
[9]Krüger A,Rammler K,Ziring E,et al.Percutaneous minimally invasive instrumentation for traumatic thoracic and lumbar fractures:a prospective analysis[J].Acta Orthop Belg,2012,78(3):376-381.
[10]林子丰,王万明,魏梅洋.椎旁肌间隙入路和传统后正中入路治疗胸腰椎骨折的前瞻性研究[J].创伤外科杂志,2013,15(6):526-530.
[11]吴继彬,郭开今,袁锋,等.经椎旁肌入路结合伤椎固定治疗胸腰段椎体骨折[J].中国矫形外科杂志,2016,24(8):697-701.
[12]何升华,马笃军,孙志涛,等.MAST Quadrant通道下椎旁肌间隙入路经伤椎椎弓根植骨治疗胸腰椎爆裂骨折[J].中国骨伤,2015,28(1):17-20.