新型脊柱外固定器系统联合经皮椎体成形术治疗胸腰椎骨折

Therapeutic effect of new-style spinal external fixation with percutaneous vertebroplasty in the treatment of thoracolumbar spinal fracture

目的探讨新型脊柱外固定器系统联合经皮椎体成形术治疗胸腰椎骨折的疗效。方法采用新型脊柱外固定器系统联合经皮椎体成形术治疗胸腰椎骨折16例,并与同期的16例行传统切开椎弓根螺钉内固定术的患者比较围手术期参数与影像学指标。结果所有患者的术后椎体高度、后凸Cobb角及矢状面指数等较术前均具有显著的恢复(P<0.01),2组间术前、术后影像学观察指标差异并无显著的统计学意义(P>0.05)。微创组较传统切开组不仅手术时间和住院时间明显缩短,而且术中出血量和术后引流量显著减少(P<0.01)。随访1年后,32例患者的伤椎前缘高度均有一定程度的丢失,且微创组较传统切开组明显。结论新型脊柱外固定器系统操作简便,具有创伤小、出血少、恢复快等优点,但同时也存在X线暴露时间长,随访时伤椎前缘高度丢失等不足,有待进一步改进。

Objective To investigate the effect of new-style spinal external fixation with percutaneous vertebroplasty in the treatment of thoracolumbar spinal fracture. Methods Sixteen patients were treated by new-style spinal external fixation with percutaneous vertebroplasty, and other 16 patients were treated by traditional pedicle screw fixation. The data of perioperative period parameters and radiographic parameters were compared. Results There were some differences between pre-operation and post-opreration in column height, Cobb＇ s angle and sagittal plane index （ P 〈 0.01 ）, and there was no difference between the 2 groups＇in radiographic parameters （ P 〉 0.05 ）. Compared with traditional group, there was less operative time, length of stay, bleeding volume and derivative volume in miro-invasive group（P 〈 0.01 ）. After follow-up for 1 year, 32 patients＇ ante- rior column height lost at different degree, and it was more significant in miro-invasive group. Conclusion The new-style spinal external fixation has such advantage as simple operation, less bleeding and rapid recovery. But it results in more time in X-ray and the lost of anterior column height, and this technique would be improved in the future.