后路内窥镜下(X-tube)椎弓根螺钉内固定治疗胸腰椎骨折

Treatment of thoracolumbar fracture with pedicle screw system under endoscopy assisted X-tube system

[目的]探讨微创技术治疗胸腰椎骨折的适应证和初步体会。[方法]选择21例单纯胸腰椎骨折、不伴有神经损伤、无需行椎板减压的损伤，在C型臂X线机定位下行胸腰椎骨折上下位椎椎弓根螺钉内固定，手术采用棘突中轴线旁开2cm各做一个切口长3cm，固定和复位均在这4个小切口内完成。[结果]21例患者经术后12—18个月（平均14个月）随访，X线片示骨折椎体均获得良好复位及固定，患者腰部功能恢复良好。[结论]后路内窥镜下（X—tube）胸腰椎骨折椎弓根螺钉复位内固定术与传统手术相比，技术操作难度并不太大，适用于单纯胸腰椎骨折、不伴有神经损伤、无需行椎板减压的患者，具有手术切口小、出血少、恢复快等优点，

[ Objective ] To investigate the clinical effects of the treatment of thoraeolurnbar fracture with pediele screw system under endoscopy assisted X-tube system. [ Method] Twenty-one eases of pure thracolumbar fracture without neural impairment were treated with pediele screw system under endoscopy assisted X-tube system. With the image intensifler,the pediele based in the affected segments were localized and exposed through 4 small incisions （3era）. Transpedicular fixation and reduction by endoscopy assisted X-tube system were performed through the 4 small incisions. [ Result] Twenty-one cases were followed up for 12 -18 months （averaged, 14 months）. Radiography showed good reduction fixation of the vertebral bodies, good correction of the kyphosis defornlities and good restoration of lumbar motion. [ Conclusion] The treatment of thoraeolumbar fracture with pedicle screw system under endoscopy assisted X-tube system is indicated for thoraeolumbar fracture without neural impairment. This tech- nique has advantages of minimal invasion and early functional recovery.