经皮椎弓根螺钉治疗多节段非相邻型胸腰椎骨折

Percutaneous pedicle screw fixation for the treatment of multiple-level noncontiguous thoracolumbar fracture

目的探讨经皮椎弓根螺钉治疗无神经损伤的多节段非相邻型胸腰椎骨折的临床疗效。方法选取17例无神经损伤的多节段非相邻型胸腰椎骨折患者,均行经皮椎弓根螺钉内固定术,观察手术前后椎体前缘高度百分比和Cobb角变化。结果患者均获得随访,时间12~26(15.7±4.3)个月。无伤口感染及内固定物松动、断裂等情况发生。骨折均获骨性愈合。Cobb角和椎体前缘高度百分比术后3 d均优于术前(P<0.001)。Cobb角、椎体前缘高度百分比末次随访与术后3 d比较差异均无统计学意义(P>0.05),长节段和短节段椎体前缘高度百分比、Cobb角比较差异均无统计学意义(P>0.05)。结论经皮椎弓根螺钉治疗无神经损伤的多节段非相邻型胸腰椎骨折是一种安全、有效的微创手术方法。

Objective To investigate the clinical effect of percutaneous pedicle screw fixation for the treatment of multiple-level noncontiguous thoracolumbar fractures without nerve injuries.Methods The 17 patients of multiple-level noncontiguous thoracolumbar fracture were performed with percutaneous pedicle screws fixation.The percentage of vertebral anterior height and Cobb angles were observed before and after operation.Results All patients were followed up for 12~26(15.7±4.3)months.No incision infection,loosen or fracture of internal fixation occurred in these patients.Bony healing was achieved in all cases.The Cobb angle and the percentage of vertebral anterior height at 3 d after operation were better than those before operation(P<0.001).There were no significant differences in Cobb angle and the percentage of vertebral anterior height between the last follow-up and 3 d after operation(P>0.05).There were no significant differences in the percentage of vertebral anterior height and Cobb angle between long and short segments(P>0.05).Conclusions Percutaneous pedicle screw fixation provides a safe,effective and minimally invasive surgery method for multiple-level noncontiguous thoracolumbar fractures without nerve injuries.