微创经皮椎弓根螺钉治疗胸腰椎骨折疗效观察

The Efficacy Observation of Minimally Invasive Pereutaneous Pediele Screw Fixation for Thoracolumbar Fracture

目的：探讨微创经皮椎弓根螺钉内固定系统治疗无神经损伤症状胸腰椎骨折的效果。方法：对2012年9月-2013年9月我院收治的40例无神经症状的单节段胸腰椎骨折患者资料进行回顾性分析，分别采用MANTIS（Stryker，美国）内固定系统经皮穿刺（微创组，20例）和传统开放手术（开放组，20例）跨伤椎固定。对两组患者的围手术期指标及术后的治疗效果进行比较。结果：所有患者术后随访6～15个月（平均8．4个月）。微创组中患者的住院时间、术中出血量、术后切口引流量、下床时间等较开放组均明显降低，差异均有统计学意义（P〈0．05）；微创组术后及末次随访中伤椎Cobb角、椎体前缘高度比值、Worter指数等与开放组比较差异无统计学意义（P〉0．05）；而微创组术后VAS、0DI评分明显优于开放组，差异均有统计学意义（P〈0．05）。结论：与传统的开放手术相比，微创经皮椎弓根螺钉内固定技术具有创伤小、住院时间短、术后康复快、术后并发症少等优点，且矫正效果满意，是治疗胸腰椎骨折安全可靠的方式。

Objective：To investigate the efficacy of minimally invasive percutaneous pedicle screws internal fixation for thoracolumber fractures without neural symptom.Methods：Each 20 cases of thoracolumbar fractures without neural symptom were treated by minimally invasive percutaneous pedicle screw internal fixation of MANTIS internal fixation system（Stryker,America）and traditional treatment of open reduction and internal fixation（ORIF）（across the injured vertebra）.A retrospective analysis was performed to compare the operative indicators and the postoperative treatment effects between the two groups.Results：After an average follow-up of 8.4months（6-15months）,it was indicated that the minimally invasive percutaneous group had shorter hospitalization days,intraoperative bleeding,postoperative drainage and the postoperative time in bed,which were significantly less than the open reduction group（P〈0.05）.The data of the Cobb angle,the ratio of the leading edge height of vertebral body and Worter index of the injured vertebra between the two groups were not significantly different（P〉0.05）.The minimally invasive group＇s VAS and Oswestry scores after operation were significantly better than the open reduction group（P〈0.05）.Conclusion：Compared with traditional open fixation approach,minimally invasive percutaneous pedicle screw fixation technique not only has merits of fewer traumas,shorter hospital stay,faster postoperative recovery,and less postoperative complications,but also has a satisfied efficacy.It is an safe and reliable way for the treatment of thoracolumbar fractures.