微创经皮穿刺椎弓根内固定术治疗胸腰椎骨折的早期疗效观察

目的:评价微创经皮穿刺椎弓根内固定术在胸腰椎骨折中的治疗效果。方法:回顾分析胸腰椎骨折18例,Sextant组7例,常规手术组10例,从手术时间、术中出血量、平均住院天数及视觉模拟疼痛评分(Visual analogue scale,VAS)方面进行疗效比较。结果:Sextant组平均手术时间(174.3±13.7)min,平均术中出血量(69.4±23.1)ml,平均住院天数为(10.4±0.91)d,术前VAS评分(7.0±1.0)分,术后(3.0±0.7)分。常规手术组平均手术时间(231.5±33.7)min,平均术中出血量(372.4±50.6)ml,平均住院天数为(13.1±1.4)d,术前VAS评分(7.2±0.92)分,术后(1.9±0.74)分。Sextant固定组的手术时间、术中出血量,平均住院天数均少于常规固定组,差异有统计学意义(P<0.05)。两组间术前或术后VAS评分结果相似(P>0.05)。结论:在严格掌握手术适应证的前提下,微创经皮穿刺椎弓根内固定术是治疗胸腰椎骨折的较好选择。

Early outcome of percutaneous pedicle screw fixation in thoracicolumbar fracture

Objective： To assess the therapeutic effects of percutaneous pedicle screw fixation in treatment of thoracicolumbar fracture by minimally invasive pedicle screw system. Methods ： Eighteen cases with thoraciclumbar fracture were reviewed by grouping into Sextant approach undergone percutaneous screw fixation with a minimally invasive pedicle screw system （ n = 8 ） and procedure with conventional pedicle screw fixation （ n = 10）. The results from both groups were assessed conceruing the duration of the surgery,intraoperative blood loss, average days of hospital stay and visual analogue scale（VAS）. Results ： The duration of operation for the Sextant group was （ 174.3 ± 13.7 ） rain vs（231.5 ± 33.7 ） rain in the conventional pedicle screw fixation group （ P 〈 0.05 ）, but the mean blood loss during operation in the former was （ 69.4 ± 23.1 ） ml vs （ 372.4± 50.6） ml of the latter（ P 〈 0.05 ）. The hospital stay after operation group lasted （ 10. 4 ± 0. 91 ） d for the Sextant group in comparison with （ 13.1± 1.4） d for the conventional approach group （ P 〈 0.05 ）. The pre-and postoperative VAS for the former was （7.0 ± 1.0） and （3.0 ± 0.7） while that accounted for （7.2 ± 0.92 ） and （ 1.9 ± 0.74） for the latter, respectively, which showed no significant difference in the improvement of VAS between the two groups. Conclusion ： Percutaneous pedicle screw fixation in treating thoracicolumbar fracture by minimally invasive pedicle screw system is preferable given careful evaluation of the surgical indications.