微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的临床疗效分析

The clinical outcome analysis of minimally invasive percutaneous pedicle screws for thoracolumbar fractures

目的探讨微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的临床疗效。方法 2008-03-2010-12采用微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折患者52例,收集患者的围手术期指标、中期随访的影像学指标、腰背疼痛改善情况进行统计学分析。结果所有患者均获得18个月至48个月随访,平均32个月。本组病例手术时间48±22 min,术中出血量为100±25 ml,切口长度68±5.4 mm,住院天数9±2.1 d。所有患者术后疼痛均明显缓解,与术前比较有统计学差异(P<0.05)。手术前后矢状位后凸Cobb角、矢状位指数、伤椎椎体前缘高度的比较均有显著性差异(P<0.05)。术中无一例出现医源性神经根损伤,术后无明显并发症发生。结论微创经皮椎弓根螺钉固定治疗胸腰椎骨折安全可靠、创伤小、出血少、恢复快、住院时间短、术后并发症少。

Objective To explore the clinical results of minimally invasive percutaneous pedicle screw fixation for thoracolumbar fracture. Methods From March 2008 to july 2010,52 thoracolum- bar fracture patients without neurological symptoms in our department were enrolled in the re- search,treated with minimally invasive percutaneous pedicle screw fixation. The perioperative index, peri-and postoperative radiography,relief of the low back pain and general health status were docu- mented and analyzed. Results All patients had been followed up for 18 to 48 months, 32months on were average. Mean operative time were 48_＋22min and blood loss were 100＋25ml,Mean length of incision were 68＋5.4mm and Mean time in hospital were 9＋2.1d days. VAS of back pain were improved obviously in all the patients. The Cobb＇s angle,sagittal index,and anterior height of the fracture vertebral body were all significantly improved after operation （P〈0.05）. There were not any complications happened in these patients. Conclusion Minimally invasive percutaneous pedicle screw fixation,which provide quick recovery and short hospital stay,is a effective method to treat thoracolumbar fracture. This procedure is simple,safe,less complication and blood loss than the original operation,and the result is comparable to the traditional open operation.