微创经皮手术与开放手术椎弓根钉内固定治疗胸腰椎骨折的临床疗效对比

Comparison of the clinical effects between minimally invasive percutaneous operation and open operation with pedicle screw fixation in the treatment of thoracolumbar fractures

为了对比微创经皮手术与开放手术椎弓根钉内固定治疗胸腰椎骨折的临床疗效,收集了104例胸腰椎骨折患者的临床资料进行回顾性分析。患者均采取椎弓根钉内固定术治疗,按采取的手术方法分为微创经皮手术组和开放手术组。所有患者术后均获得12~18个月的随访。结果显示,微创经皮手术组的切口长度、手术时间、出血量、术后3天VAS评分和不良切口愈合率均显著低于开放手术组,但术中X线透视次数显著多于开放手术组;两组术后1年骨折椎体前缘高度比值、Cobb's角、Oswestry功能障碍指数和内固定失败率无显著差异(P>0.05)。因此微创经皮手术与开放手术椎弓根钉内固定治疗胸腰椎骨折,都可以获得满意的临床疗效。前者虽然存在较多的X线暴露的缺点,但创伤更小,适合在临床上推广应用。

In order to compare the clinical effects of minimally invasive percutaneous surgery and open surgery with pedicle screw internal fixation in the treatment of thoracolumbar fractures,the clinical data of 104 patients with thoracolumbar fractures were collected for retrospective analysis.All patients were treated with pedicle screw internal fixation.According to the operation methods,they were divided into minimally invasive percutaneous operation group and open operation group.All patients were followed up for 12-18 months.The results showed that the incision length,operation time,bleeding volume,VAS score and bad wound healing rate in the minimally invasive percutaneous operation group were lower than those in the open operation group,but the times of X-ray fluoroscopy in the operation group were more than those in the open operation group.There was no significant difference between the two groups in the height ratio of anterior edge of fracture vertebral body,Cobb's angle,Oswestry dysfunction index and failure rate of internal fixation(P>0.05).Therefore,minimally invasive percutaneous surgery and open surgery pedicle screw internal fixation for thoracolumbar fractures can achieve satisfactory clinical results.Although the former has more disadvantages of X-ray exposure,it has less trauma and is suitable for clinical application.