体位复位经皮Sextant椎弓根螺钉内固定治疗胸腰椎骨折临床分析

目的探讨体位复位并经皮Sextant椎弓根螺钉内固定治疗胸腰椎骨折的临床效果。方法采用体位复位并Sextant微创脊柱系统治疗胸腰椎骨折32例；测量手术前后椎体前缘高度变化及Cobb角的矫正程度，以及手术时间、住院时间、术中出血量。结果所有病人的术后椎体高度和后凸Cobb角较术前均具有显著的恢复(P<0.01)。微创组较传统切开组不仅手术时间和住院时间明显缩短，而且术中出血量和术后引流量显著减少。随访期间无内固定失败病例，末次随访椎体高度和后凸矫正无明显丢失。结论体位复位并经皮Sextant椎弓根螺钉内固定术操作简便，具有创伤小、出血少、恢复快等优点，主要缺点在于撑开复位程度有限和X线暴露时间较长；而体位复位能有效克服Sextant椎弓根螺钉内固定系统撑开复位程度有限的缺点。

Postural Reduction and Percutaneous Sextant Pedicle Screw Internal Fixation in the Treatment of Thoracolumbar Fractures

ObjectiveTo discuss position reduction and percutaneous Sextant pedicle screw internal fixation for treatment of thoracolumbar fractures.MethodsUse position reset and Sextant minimally invasive spine system in treatment of 32 cases of thoracolumbar fractures and measure fanterior flange height changes before and after operation and correction of Cobb Angle,as well as the operation time,intraoperative blood loss,hospitalization time.ResultAll the patient's postoperative vertebral body height and convex Cobb Angle compared with preoperative have remarkable recovery(P<0.01).Minimally invasive group compared with traditional incision group not only significantly shortened the operation time and hospitalization time,but also significantly reduced intraoperative blood loss and postoperative flow.Ther was no internal fixation failure cases during the follow-up period,and the last follow-up of vertebral body height and the protruding after correction has no obvious loss.ConclusionsPosition reduction and percutaneous Sextant pedicle screw internal fixation operation is simple,with the advantages of small trauma,less bleeding,faster recovery.The main drawback is that open reduction is limited and X-ray exposure time is longer than the other.Resetting the position can effectively overcome the Sextant pedicle screws degree limited open reduction and internal fixation system faults.