正中小切口减压结合经皮椎弓根螺钉内固定术的临床应用分析

目的：观察正中小切口减压结合经皮椎弓根螺钉内固定术对胸腰椎压缩性骨折的治疗效果。方法：以2014年3月～2015年6月在我院接受治疗的胸腰椎骨折患者为观察对象。根据其治疗方式小切口组（52例）和开放手术组（48例）。观察两组患者手术一般情况，比较两组患者疗效相关指标和术后并发症发生率的差异。结果：小切口组患者肌肉剥离长度明显较开放手术组短，术中出血量和术后引流量明显较开放手术组少，两组患者手术时间无明显差别；两组患者手术前椎体前缘压缩度、后凸Cobb's角、VAS和ODI得分无明显差别，手术后两组椎体前缘压缩度和后凸Cobb's角较术前均明显改善，且小切口组改善更为明显；手术后1个月和6个月随访结果显示两组患者VAS和ODI得分均较手术前降低，且小切口组的得分均低于开放手术组，差别具有统计学意义；小切口组患者术后感染发生率明显低于开放手术组，两组患者神经根损伤和二次骨折发生率无明显差别。结论：正中小切口减压结合经皮椎弓根螺钉内固定术对胸腰椎骨折有较好的治疗效果，可明显改善患者的相关症状，降低并发症发生率。

Clinical application of small incision decompression combined with percutaneous pedicle screw fixation

Objective To observe the positive small incision decompression combined with percutaneous pedicle screw fix-ation for thoracolumbar compression fracture treatment. Methods Fracture patients recived thoracolumbar in our hospital from March 2014 to June 2015 were selected as objiect. According to the treatment methods, which were divided into small incision group(52 cases)and open surgery group(48 cases). Observed the general surgery of the two groups, compared the incidence of complications related to differences in outcome indicators were between the two groups after operation. Results Small incision in patients with The muscle stripping length significantly compared with open surgery group, intraoperative blood loss and postop-erative drainage volume was significantly higher than the open surgery group, no significant difference between the two groups of patients with operation time;The anterior vertebral compression degree, Cobb’s angle, vas and ODI score of the two groups had no significant difference. After surgery, the vertebral compression degree and after Cobb’s angle of the two groups all signifi-cantly improved and small incision group improved was more obvious;1 months after surgery and 6 months follow-up showed that two patients with VAS and ODI scores were lower than those before operation, and small incision group were all lower than those of the open surgery group, the difference was statistically significant. The incidence of infection was significantly lower than that in the open surgery group small incision group patients, two groups of patients with nerve root injury and two fracture rates were not significantly different. Conclusion The small incision decompression combined with percutaneous pedicle screw fixation of thoracolumbar fracture has good curative effect, which can significantly improve the symptoms of patients, and reduce the incidence of complications.