微创椎弓根螺钉经伤椎固定治疗胸腰椎骨折

Minimally Invasive Pedicle Screw Fixation Through Injury of Thoracic and Lumbar Vertebral Fractures

目的：探讨微创椎弓根螺钉经伤椎内固定术在治疗胸腰椎骨折后路手术中的临床疗效和应用价值。方法：采用微创椎弓根螺钉经伤椎内固定经皮椎弓根螺钉内固定术治疗胸腰椎爆裂性骨折20例,手术均在气管插管全身麻醉下进行,采用俯卧位,棘突旁作1~2厘米小切口,经皮椎弓根螺钉内固定经伤椎固定撑开椎体复位。术后定期复查X线片以观察固定节段的稳定性和骨折愈合率。结果：术后20例全部获得随访,随访6~12个月,平均8个月。椎体撑开复位,脊柱序列恢复良好,无骨折不融合,无椎管内神经压迫等并发症。内固定节段稳定,胸腰椎椎间高度及生理曲度都得到良好重建及维持,未出现内固定断裂、松动及脱出,无血管、神经损伤等并发症。结论：微创椎弓根螺钉经伤椎内固定术治疗胸腰椎骨折,防止了棘突旁肌肉和韧带的剥离,完全恢复脊柱序列,复位良好,腰背肌肉力量得到了保护,可早期下床活动,方便术后护理和功能锻炼,为一积极有效的方法。

Objective： To investigate the clinical efficacy of minimally invasive pedicle fixation and application value in the treatment of thoracolumbar fracture surgery in the posterior screw the injured vertebrae.Methods： Minimally invasive pedicle screw fixation was injured vertebra fixation treatment by percutaneous pedicle screw within the thoracolumbar burst fracture 20 cases,the operations were carried out in endotracheal intubation under general anesthesia in the prone position,the spinous process as a-2 cm incision,percutaneous pedicle screw fixation was injured vertebra vertebral distraction reset.Periodic review of postoperative X-ray to see stability and fracture healing rate fixed segment.Results： 20 cases of surgery were followed u Pfor 6 to 12 months,an average of eight months.Vertebral distraction reduction,spinal sequence recovered well without fracture and fusion,is no spinal nerve compression and other complications.Fixed segments were stable,thoracic and lumbar intervertebral height and lordosis have been rebuilding and maintaining good,fracture fixation does not appear,loose and prolapse,no vascular complications,such as nerve damage.Conclusion： Minimally invasive pedicle screw fixation through the wound treatment of thoracolumbar vertebral fractures,muscle and ligaments to prevent stripping the spinous process,fully restored spine sequence,reset good back muscle strength have been protected,early ambulation,facilitate postoperative care and functional exercise,as a positive and effective way.