微创经皮穿刺椎弓根内固定术治疗胸腰椎骨折的疗效

Effect of perutaneous pedicle screw fixation on thoraco-lumbar fractures

目的探讨微创经皮穿刺椎弓根内固定术治疗胸腰段骨折的可行性及，临床应用价值。方法将70例胸腰椎骨折患者分为微创经皮穿刺椎弓根内固定术组、常规后路切开复位椎弓根内固定术组各35例，观察两组切口长度、手术时间、术中出血量、术后引流量、平均住院天数，比较两组术前、术后伤椎前缘高度百分比及后凸Cobb’s角改变。结果与常规手术组相比，微创经皮组的切口长度、手术时间、术中出血量及术后引流量均明显减少（P〈0．05）。而两组手术前后的伤椎前缘高度增加的百分比、手术前后Cobb’s角减少的度数差异均无统计学意义（P〉0．05）。结论微创经皮椎弓根螺钉内固定技术操作相对简便，具有创伤小，出血少，手术时间短，术后恢复快等近期优点，在严格掌握手术适应证的前提下，微创经皮穿刺椎弓根内固定术是治疗胸腰椎骨折的较好选择。

Objective To study the feasibility and clinicqal value of perutaneous pedicle screw fixation in treatment of thoraco-lumbar fractures. Methods Seventy patients with thoraco-lumbar frac- tures were treated with the posterior percutaneous or open pediele screw fixation respectively. Operation time, incision size, the bleeding volume, the heigh of the anterior border, the Cobb＇ s angles of scoliosis were compared. Results Compared with the open pedicle screw fixation group, patients in the multi- level sextant percutaneous pedicle screw fixation group experienced a significant smaller incision size, a significant decrease in sm＇gical blood loss and surgical draining loss. Surgical time shortened significantly. There were significant postopera- tive improvement in Cobb＇ s angle and anterior height of fracture vertebral body in the multi-level sextant percutaneous pedicle screw fixation groups Conclusions This study shows that prutaneous pedicle screw fixation has the advantages of simple ma- nipulation, less trauma and bleeding, short operation time, quick recovery. Percutaneous pedicle screw fixation in treating thoracicolumbar fracture by minimally invasive pedicle screw system is preferable choice of the surgical indications.