微創經皮椎弓根螺釘內固定治療胸腰椎骨折的效果觀察

周建敏等

[摘要] 目的 探討微創經皮椎弓根螺釘內固定治療胸腰椎骨折的臨床效果。 方法 選取2011年4月～2013年11月在本院就診的胸腰椎骨折患者64例，隨機分為微創組和開放組，每組各32例。微創組患者使用微創經皮椎弓根螺釘內固定進行治療，開放組患者使用傳統開放椎弓根螺釘內固定進行治療。比較兩者患者的手術時間、術中出血量、術后引流量、帶支具離床時間、住院時間、視覺模擬評分（VAS）、Cobb角和椎體前緣高度百分比等指標。 結果 微創組的手術時間、術中出血量、術后引流量、帶支具離床時間和住院時間與開放組比較，差異有統計學意義（P<0.05）；兩組術后半年的VAS評分、Cobb角和椎體前緣高度百分比與術前比較，差異有統計學意義（P<0.05）；微創組術后半年的VAS評分、Cobb角和椎體前緣高度百分比與開放組比較，差異有統計學意義（P<0.05）。 結論 微創經皮椎弓根螺釘內固定對胸腰椎骨折的臨床治療效果優于傳統開放椎弓根螺釘內固定，患者出血少、恢復快。

[關鍵詞] 微創經皮椎弓根螺釘內固定；胸腰椎骨折；臨床效果

[中圖分類號] R683 [文獻標識碼] A [文章編號] 1674-4721（2014）08（a）-0048-03

Effect observation of minimally invasive percutaneous pedicle screws osteosynthesis in the treatment of thoracolumbar fracture

ZHOU Jian-min SHUANG Ou LI Jian WU Chong

Department of Orthopaedics，Shangrao People′s Hospital of Jiangxi Province，Shangrao 334000，China

[Abstract] Objective To explore the clinical effect of minimally invasive percutaneous pedicle screws osteosynthesis （MIPPSO） treating thoracolumbar fracture. Methods 64 patients with thoracolumbar fracture visited our hospital from April 2011 to November 2013 were selected and evenly divided into the minimally invasive group and the open group in random.In the minimally invasive group， patients were treated by MIPPSO，while in the open group，the traditional openness of pedicle screws osteosynthesis were provided.The indexes like operation time， intraoperative amount of bleeding，postoperative amount of drainage，time of being off bed with brace，hospital stay，score of visual analogue scale （VAS），Cobb angle， and percentage of anterior height in vertebral body etc. were compared in both groups. Results In the minimally invasive group，the indexes of operation time， intraoperative amount of bleeding， postoperative amount of drainage，time of being off bed with brace， and hospital stay displayed statistical difference in comparison with those in the open group （P<0.05）.The VAS score，Cobb angle，and percentage of anterior height in vertebral body after half a year operation in the two groups both showed statistical differences in comparison with those before surgery （P<0.05）. Besides，the VAS score，Cobb angle，and percentage of anterior height in vertebral body after half a year operation in the minimally invasive group displayed statistical difference after comparing those in the open group （P<0.05）. Conclusion In the treatment of thoracolumbar vertebral fracture，the clinical therapeutic effect of MIPPSO is superior to that by traditional openness of pedicle screws osteosynthesis at advantages of little blood loss and quick recovery.endprint