经皮椎弓根螺钉固定与开放式椎弓根螺钉固定对胸腰段A3型骨折的治疗效果研究

Treatment of thoracolumbar A3 type fractures with percutaneous pedicle screw fixation and open pedicle screw fixation

目的 :研究开放式椎弓根螺钉固定以及经皮椎弓根螺钉固定对胸腰段A3型骨折的治疗效果。方法 :选择2015年1月～2017年12月在我院骨外科进行诊治的100例胸腰段A3型骨折患者,随机分为两组。对照组采取开放式椎弓根螺钉固定,观察组采取经皮椎弓根螺钉固定。比较两组的临床治疗效果。结果 :两组的优良率相比无明显的差异;观察组的手术时间、切口长度、术后引流量、术中出血量均明显低于对照组;两组手术后的后凸角度均明显降低,伤椎前后缘高度比均明显升高,但两组间相比无明显的差异;观察组的并发症发生率明显低于对照组。结论 :开放式椎弓根螺钉固定以及经皮椎弓根螺钉固定对于胸腰段A3型骨折均具有较好的治疗效果,但后者具有手术切口小、手术时间短、并发症少和出血量少等优点,值得应用推广。

Objective To study the effect of percutaneous pedicle screw fixation and open pedicle screw fixation on horacolumbar A3 type fractures.Methods Selected 100 cases of patients with horacolumbar A3 type fractures who were treated in our hospital from January 2015 to December 2017,divided into two groups randomly.The control group was treated with open pedicle screw fixation,and the observation group was treated with percutaneous pedicle screw fixation.Results There was no significant difference in the good rate between the two groups;the operation time,the length of the incision,the flow rate after the operation and the amount of bleeding in the operation were significantly lower than those of the control group;the kyphosis angle of the two groups decreased significantly,and the height ratio of the anterior and posterior margin of the injured vertebra increased significantly,but there was no significant difference between the two groups,and the incidence of complications in the observation group was significantly lower than control group.Conclusion Open pedicle screw fixation and percutaneous pedicle screw fixation have good therapeutic effect on A3 type fracture of the thoracolumbar segment,but the latter has the advantages of small incision,short operation time,less complications and less bleeding.