微创经皮椎弓根螺钉内固定治疗青壮年单纯胸腰椎压缩性骨折

目的比较经皮微创椎弓根螺钉内固定与常规椎弓根螺钉内固定治疗青壮年单纯胸腰椎椎体压缩性骨折的临床疗效。方法2008年3月～2010年10月20例单节段胸腰椎椎体压缩性骨折，均无神经受压情况，分别行经皮微创椎弓根螺钉内固定（实验组，n=10）和常规切开椎弓根螺钉内固定（常规组，n=10）。比较2组手术时间、术中出血量、术后VAS评分、术后1周和3个月骨折复位情况（Cobb角），以及3个月后骨折复位再丢失情况。结果2组均未出现内固定相关并发症。实验组术中出血量（58．0±19．3）ml显著少于常规组（80．0±14．1）ml（t=-2．911，P=0．009），手术时间（58．0±7．1）min显著短于常规组（65．0±6．2）min（t=-2．348，P=0．030），术后VAS评分（5．6±1．0）分显著少于常规组（7．1±0．7）分（t=-3．886，P=0．001）。实验组术后1周、3个月Cobb角以及丢失Cobb角分别为（13．5±5．8）°、（15．8±5．6）°、0°（0°～10°），常规组相应指标分别为（12．5±7．2）°、（15．0±3．3）°、0°（0°～10°），2组比较无统计学差异（P〉0．05）。结论对于单纯单节段椎体压缩性骨折，经皮微创椎弓根螺钉内固定与常规椎弓根螺钉内固定临床疗效相当。

Percutaneous Pedicle Screw Fixation through the Pedicle of Fractured Vertebra for Compression Thoracolumbar Fractures in Young Adult Patients

Objective To evaluate the efficacy of percutaneous pedicle screw fixation （PPSF） through the pedicle of the fractured vertebra for young adults with compression thoracolumbar fractures. Methods From March 2008 to October 2010, l0 young adult patients with compression thoracolumbar fractures received PPSF through the pedicle of the fractured vertebra in our hospital （experimental group） , another 10 patients who received conventional procedures were set as a control group. The operation time, intraoperative blood loss, postoperative VAS, radiological assessment of the sagittal Cobb angle in 1 week and 3 months, and loss of reduction in 3 months were compared between the two groups. Results Neither of the groups showed fixation-related complications. Experimental group showed significantly more intraoperative blood loss, shorter operation time, and lower VAS scores that the control （58.0±19.3） ml vs. （80.0 ±14.1） ml （t= -2.911, P=0.009）; （58.0±7. 1） rain vs. （65.0 ±6.2） rain （t= -2.348, P=0.030）; 5.6±1.0 vs. 7. 1 ±0.7 （t = -3.886, P =0.001）]. No significant difference was detected in the radiological assessment of the sagittal Cobb angle in 1 week and 3 months, and loss of reduction in 3 months （ 13.5± 5. 8） °, （15.8~5.6）°, and0° （0°-10°） vs. （12.5±7.2）°, （15.0±3.3）°, and 0° （0°-10°）, all P〉0.05]. Conclusion PPSF through the pediclc of the fractured vertebra is a minimally-invasivc and effective choice for young adult patients with single compression thoracolumbar fracture.