过伸复位结合经皮实心椎弓根钉短节段固定治疗胸腰段单节段骨折

Hyperextension Combined with Percutaneous Solid Pedicle Screw Treatment of Thoracolumbar Single Segment Fracture

目的:回顾性分析过伸复位结合经皮实心椎弓根钉治疗胸腰段骨折的手术技巧及疗效。方法:采用麻醉后术前过伸复位、经皮实心椎弓根后路短节段置钉治疗胸腰段单节段椎体骨折不伴脊髓损伤的19例患者进行回顾性分析,比较术前、复位后及术后Cobb角、手术前后椎体前缘高度丢失率、手术前后视觉模拟评分法(Visual Analogue Scale/Score,VAS)疼痛评分、住院时间等指标作出疗效评定。结果:术后无切口感染,无医源性脊髄和大血管损伤,无内固定松动、断裂等并发症,无死亡病例。随访时间6-18个月,平均12.6个月。结果显示术后伤椎Cobb角明显减小,伤椎前缘高度恢复明显,术后VAS评分明显低于术前。结论:应用过伸复位结合经皮实心椎弓根钉治疗胸腰椎单节段骨折,骨折复位和固定效果良好,具有创伤小、疼痛轻、并发症少等优点,符合快速康复理念。

Objective:Retrospective analysis of hyperextension combined with percutaneous solid pjedicle screw treatment of thoracolumbar single segment fracture surgery skills and efficacy.Methods:19 patients with single segment thoracolumbar fracture without spinal cord injury were retrospectively analyzed by means of preoperative hyperextension postoperative anesthesia and percutaneous solid percutaneous pedicle posterior short segment nailing.Postoperative Cobb angle,height loss of anterior vertebral body before and after surgery,preoperative and postoperative VAS score,length of stay and other indicators of efficacy evaluation.Results:No incision infection,no iatrogenic spinal cord and macrovascular injury,no complications such as loosening and rupture of internal fixation,no deaths.Follow-up time 6-18 months,an average of 12.6 months.The results showed that the Cobb angle of injured vertebrae decreased significantly,the height of injured vertebrae recovered obviously,and the postoperative VAS score was significantly lower than that before operation.Conclusion:Hyperextension combined with percutaneous solid pedicle screw treatment of thoracolumbar single segment fracture,fracture reduction and fixation effect is good,with less trauma,less pain,fewer complications,In line with the concept of enhanced recovery after surgery.