微创经皮与传统切开椎弓根螺钉内固定治疗Magerl A2、A3型胸腰椎骨折疗效比较

目的比较微创经皮与传统切开椎弓根螺钉内固定治疗Magerl A2、A3型胸腰椎骨折的临床疗效。方法对68例Magerl A2、A3型胸腰椎骨折患者分别采用微创经皮椎弓根螺钉内固定(微创经皮组,35例)和传统切开椎弓根螺钉内固定(传统切开组,33例)治疗。比较两组手术情况、术后疼痛VAS评分、术后Cobb角及伤椎前缘高度压缩率。结果患者均获得随访,时间48~118个月。术中失血量、手术时间、术后下床活动时间、住院时间、重返工作时间微创经皮组均优于传统切开组(P<0.05)。两组术后及末次随访VAS评分、Cobb角及伤椎前缘压缩率均优于术前(P<0.05),末次随访时,两组VAS评分比较差异有统计学意义(P<0.05),Cobb角、伤椎前缘高度压缩率比较差异均无统计学意义(P>0.05)。结论微创经皮与传统切开椎弓根螺钉内固定治疗Magerl A2、A3型胸腰椎骨折,疗效满意且相当;但微创经皮置钉创伤小,出血少,手术时间及住院时间短,术后恢复快。

Comparison efficacy of mini-invasive percutaneous and traditional open pedicle screw internal fixation for treatment of Magerl type A2,A3 thoracolumbar fractures

Objective To compare the clinical results between mini-invasive percutaneous and traditional open pedicle screw internal fixation in the treatment of Magerl type A2,A3 thoracolumbar fracture.Methods Sixty-eight patients with Magerl type A2,A3 thoracolumbar fractures were treated with mini-invasive percutaneous pedicle screw internal fixation(mini-invasive percutaneous group,n=35)and traditional open pedicle screw internal fixaiton(traditional open group,n=33).Clinical results were assessed by comparing the following parameters between the two groups,including operation situation,the postoperative pain VAS,Cobb angle and compression rate of injured vertebrae anterior height.Results All patients were followed up with a duration period of 48~118 months.The mini-invasive percutaneous group possessed significant advantages in intraoperative blood loss,operation time,active time postoperation,hospital stay,and time to return to work than traditional open group(P<0.05).Two groups with VAS,Cobb angle and compression rate of injured vertebrae anterior height at the postoperation and last follow-up were better than those of the preoperation(P<0.05).At the last follow-up,VAS of two groups had statistical difference(P<0.05),while Cobb angle and compression rate of injured vertebrae anterior height weren′t both statistically different(P>0.05).Conclusions There is good clinical curative effect and have the same clinical effect in the two groups patients treated by minimally invasive percutaneous and traditional open pedicle screw internal fixation,but the mini-invasive percutaneous pedicle screw internal fixation has the characteristics of less traumas,less bleeding,less operative time and hospital stay,faster recovery.