经皮椎弓根螺钉固定与开放式椎弓根螺钉固定对胸腰段A3型骨折的治疗效果研究
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摘要
目的 :研究开放式椎弓根螺钉固定以及经皮椎弓根螺钉固定对胸腰段A3型骨折的治疗效果。方法 :选择2015年1月～2017年12月在我院骨外科进行诊治的100例胸腰段A3型骨折患者,随机分为两组。对照组采取开放式椎弓根螺钉固定,观察组采取经皮椎弓根螺钉固定。比较两组的临床治疗效果。结果 :两组的优良率相比无明显的差异;观察组的手术时间、切口长度、术后引流量、术中出血量均明显低于对照组;两组手术后的后凸角度均明显降低,伤椎前后缘高度比均明显升高,但两组间相比无明显的差异;观察组的并发症发生率明显低于对照组。结论 :开放式椎弓根螺钉固定以及经皮椎弓根螺钉固定对于胸腰段A3型骨折均具有较好的治疗效果,但后者具有手术切口小、手术时间短、并发症少和出血量少等优点,值得应用推广。
Objective To study the effect of percutaneous pedicle screw fixation and open pedicle screw fixation on horacolumbar A3 type fractures. Methods Selected 100 cases of patients with horacolumbar A3 type fractures who were treated in our hospital from January 2015 to December 2017, divided into two groups randomly. The control group was treated with open pedicle screw fixation, and the observation group was treated with percutaneous pedicle screw fixation. Results There was no significant difference in the good rate between the two groups; the operation time, the length of the incision, the flow rate after the operation and the amount of bleeding in the operation were significantly lower than those of the control group; the kyphosis angle of the two groups decreased significantly, and the height ratio of the anterior and posterior margin of the injured vertebra increased significantly, but there was no significant difference between the two groups, and the incidence of complications in the observation group was significantly lower than control group. Conclusion Open pedicle screw fixation and percutaneous pedicle screw fixation have good therapeutic effect on A3 type fracture of the thoracolumbar segment, but the latter has the advantages of small incision, short operation time, less complications and less bleeding.
Objective To study the effect of percutaneous pedicle screw fixation and open pedicle screw fixation on horacolumbar A3 type fractures. Methods Selected 100 cases of patients with horacolumbar A3 type fractures who were treated in our hospital from January 2015 to December 2017, divided into two groups randomly. The control group was treated with open pedicle screw fixation, and the observation group was treated with percutaneous pedicle screw fixation. Results There was no significant difference in the good rate between the two groups; the operation time, the length of the incision, the flow rate after the operation and the amount of bleeding in the operation were significantly lower than those of the control group; the kyphosis angle of the two groups decreased significantly, and the height ratio of the anterior and posterior margin of the injured vertebra increased significantly, but there was no significant difference between the two groups, and the incidence of complications in the observation group was significantly lower than control group. Conclusion Open pedicle screw fixation and percutaneous pedicle screw fixation have good therapeutic effect on A3 type fracture of the thoracolumbar segment, but the latter has the advantages of small incision, short operation time, less complications and less bleeding.
引文
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[10]田爱平.经皮椎弓根螺钉内固定术与开放椎弓根螺钉内固定术治疗无神经损伤胸腰段骨折对比研究[J].山西医药杂志, 2017, 46(2):181-183.
[11]张超,皮红林,刘家矿,等.经皮微创与开放式椎弓根螺钉内固定术对胸腰椎段脊柱骨折的疗效对比[J].医学综述, 2015, v.21(5):899-901.
[12]刘进平,冯海龙,赵冬冬.微创经皮椎弓根螺钉内固定术治疗无神经症状的单节段胸腰椎骨折[J].中国现代神经疾病杂志, 2016,16(3):130-135.
[2]舒冬平,李绍刚,邓汉华.经皮微创与传统切开两种手术方式治疗胸腰椎骨折的临床疗效对比研究[J].湖南师范大学学报(医学版),2016, 13(3).
[3]邱大权,张文志,李旭,等.经皮单平面椎弓根螺钉与开放椎弓根螺钉治疗胸腰椎骨折疗效比较[J].临床骨科杂志, 2016, 19(3):262-265.
[4]胥少汀.实用骨科学[M].2版.北京:人民军医出版社, 2003:658-662.
[5]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.
[6]舒冬平,李绍刚,邓汉华,等.后路SSPI治疗A型胸腰段脊柱骨折的临床效果观察[J].西南国防医药, 2016, 26(5):526-528.
[7]王勇平.不同入路方案下胸腰椎骨折患者的外科疗效对比[J].湖南师范大学学报(医学版), 2017, 14(4).
[8]李兴中,吴恙,倪东亮,等.一期前后联合入路减压内固定术治疗A3型腰椎爆裂骨折[J].中国矫形外科杂志, 2016, 24(20):1905-1908.
[9]贾建忠,魏斌斌,张涛,等.经皮微创椎弓根钉内固定术治疗创伤性胸腰椎压缩骨折的临床效果分析[J].中国中西医结合外科杂志,2017, 23(1):26-29.
[10]田爱平.经皮椎弓根螺钉内固定术与开放椎弓根螺钉内固定术治疗无神经损伤胸腰段骨折对比研究[J].山西医药杂志, 2017, 46(2):181-183.
[11]张超,皮红林,刘家矿,等.经皮微创与开放式椎弓根螺钉内固定术对胸腰椎段脊柱骨折的疗效对比[J].医学综述, 2015, v.21(5):899-901.
[12]刘进平,冯海龙,赵冬冬.微创经皮椎弓根螺钉内固定术治疗无神经症状的单节段胸腰椎骨折[J].中国现代神经疾病杂志, 2016,16(3):130-135.