经皮椎弓根螺钉微创治疗胸腰段爆裂骨折的研究

Study of the treatment of thoracolumbar vertebral fractures by minimally invasive percutaneous pedicle screws fixation

目的：探讨经皮椎弓根螺钉微创内固定（ MIPPSO）治疗胸腰段椎体爆裂骨折的临床效果。方法采用随机数字表法将我院2010年1月～2013年1月收治的55例胸腰段椎体爆裂骨折患者分为微创组（28例）和传统组（27例），微创组采用MIPPSO法、传统组采用传统切开椎弓根螺钉内固定治疗，比较两组患者术中、术后的治疗效果及随访观察结果的差异。结果微创组的手术时间显著长于传统手术组，术中出血量、术后引流量、切口长度、住院时间均显著小于传统组且差异均具有统计学意义（ P＜0．05）。术前、术后第7天两组患者的视觉模拟评分（ VAS）比较差异不显著，术后1年微创组的VAS评分显著低于传统组（ P＜0．05）；两组患者术前、术后伤椎体相对高度、术后椎体即刻恢复度、椎体高度丢失度、术前Cobb角、术后即刻Cobb角矫正度、Cobb角丢失度差异均不显著（ P＞0．05）。结论 MIPPSO治疗胸腰段椎体爆裂骨折较传统方法创伤小，术后疼痛轻微，同时固定效果与传统手术方法无差异。

Objective To investigate the clinical effect of minimally invasive percutaneous pedicle screws fixation（ MIPPSO） in treating thoracic lumbar vertebral fractures.Methods Totally 55 patients with thoracic lum-bar vertebral burst fracture admitted in our hospital from Jan.2010 to Jan.2013 were randomly divided into minimal-ly invasive group（28 cases） and traditional group（27 cases）.The patients in minimally invasive group were treated by MIPPSO method and the patients in traditional group were treated with traditional lumbar pedicle screw fixation. The effect of the surgery and the follow up results between two groups were compared.Results The surgery time was significantly longer in minimally invasive group than that in traditional group（P＆lt;0.05）,and the intraoperative bleeding volume,postoperative drainage volume and intraoperative were significantly less than those in traditional group（ P＆lt;0.05） .The VAS score before and 7 days after surgery between two groups had no significant differ-ences,and the VAS score in minimally invasive group was significant lower than that in traditional group （ P ＆lt;0.05）;differences of relative height of injured vertebral body,recoverable degrees of vertebral body,loss degrees of vertebral height,the Cobb Angle before and after surgery,immediate postoperative engraved recovery of the vertebral body,immediate correction of Cobb Angle after surgery and the lost degrees of Cobb Angle between the two groups were not significantly different（P＆gt;0.05）.Conclusion The treatment method of MIPPSO is minimally invasive and results less pain compared with traditional surgical methos while achieves the same fixation effect as traditional method.