微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折临床效果分析

Minimally invasive percutaneous pedicle screw fixation for treatment of thoracolumbar fracture of clinical analysis efficacy

目的：观察微创经皮病椎椎弓根螺钉内固定术治疗胸腰椎骨折的疗效。方法：选择自2009年2月～2011年8月应用经皮病椎椎弓根螺钉内固定术治疗胸腰椎骨折并且随访资料完整的患者60例，根据术前、术后的JOA、Oswestry（2．0版本）及VAS评分评估和后凸Cobb′s角，椎体前缘高度，椎间隙高度比较观察临床疗效。结果：60例患者术后JOA评分较术前明显升高，术后Oswestry和VAS评分较术前明显降低，有统计学意义（P＜0．01）。后凸Cobb′s角，椎体前缘高度，椎间隙高度均较术前有明显改善，有统计学意义（ P＜00．1）。术后按照改良Macnab 疗效评定标准评定：优36例，良20例，可3例，差1例，优良率为93．3％。结论：微创经皮病椎椎弓根螺钉内固定术操作相对简便，具有切口小、创伤小，出血少，手术时间短，术后疼痛轻、术后恢复快，住院时间短等近期优点，但远期疗效尚需进一步随访。

Objective：To observe minimally percutaneous fractured disease vertebral pedicle screw fixation surgery for thoracolumbar fractures efficacy.Methods：From February 2009 to August 2011 application by the percutaneous fractured disease vertebral pedicle screw fixation surgery for thoracolumbar fractures and complete follow-up data of 60 patients , according to the preoperative and postoperative JOA,Oswestry （ 2.0 version ） and VAS score assessment and kyphosis Cobb＇s angle , anterior vertebral height , disc space height Com-pare observation clinical efficacy.Results：compared 60 patients with postoperative JOA score was significantly higher the than preoperative and postoperative Oswestry and VAS scores than preoperative significantly reduced ,was statistically significant （ P 〈0.01 ） .Kyphosis Cobb＇s angle , anterior vertebral height , disc space height compared with preoperative ,significant improvement was statistically significant （ P 〈0.01 ） .Modified Macnab evaluation criteria：Assessment：excellent in 36 cases, good in 20 cases , may in 3 cases and poor in 1 case , good rate for 93.3%.Conclusion：minimally percutaneous fractured disease vertebral pedicle screw fixation surgery might be rel-atively simple,with a small incision , less trauma, less bleeding, shorter operative time, postoperative pain, Rapid postoperative recovery , shorter hospital stay Etc Recent advantages but The long-term efficacy needs to be further follow-up.