导航辅助微创经皮穿刺椎弓根内固定术治疗胸腰椎骨折的疗效观察

目的评价导航辅助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51例,Sextant组21例,常规手术组30例,从手术切口、手术时间、出血量、术后活动时间、及数字类比疼痛评分（NAPS）等方面进行比较。结果Sextant组手术切口在（2．4±0．4）cm,为术中工作通道大小。平均手术时间（2．1±0．4）h,平均术中出血量（114．0±67．4）ml,平均下地活动时间为术后（2．0±0．7）d,术前NAPS评分（7．0±1．0）分,术后（3．0±0．7）分。常规手术组手术切口在（17．4±3．4）cm,平均手术时间（2．7±0．7）h,平均术中出血量（317．0±113．2）ml,平均下地活动时间为术后（7．2±2．5）d,术前NAPS评分（7．1±1．5）分,术后（3．1±0．8）分。结论在严格掌握手术适应证的前提下,导航辅助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。

Percutaneous pedicle screw fixation in thoracic-lumbar fracture using mini-invasive pedicle screw system guided by navigation

OBJECTIVE: To assess the therapeutic effects of thoracic-lumbar fracture fixation with percutaneous mini-invasive pedicle screw system guided by computer navigation. METHOD: Fifty-one thoracic-lumbar fracture patients were divided into two groups: Sextant group (n = 21) undergoing percutaneous screw fixation with a minimally invasive pedicle screw system, and conventional pedicle screw fixation group (n = 30). The differences in the incision size, average blood loss during operation, surgical time, time of resuming walking after operation, numerical analogous pain score, etc. were analyzed. RESULTS: The incision length of the sextant group was 2.4 +/- 0.41 cm, significantly shorter than that of the conventional pedicle screw fixation group (17.4 +/- 3.4 cm, P < 0.001). The average blood loss during operation of the sextant group was 114 +/- 67.4 ml, significantly less than that of the conventional pedicle screw fixation group (317 +/- 113.2 ml, P < 0.001). The surgical time of the sextant group was 2.1 +/- 0.4 hr, significantly shorter than that of the conventional pedicle screw fixation group (2.7 +/- 0.7, P < 0.05). The time of resuming walking after operation of the sextant group was 2.0 +/- 0.7 d, significantly shorter than that of the conventional pedicle screw fixation group (7.2 +/- 2.5 d, P < 0.001). The postoperative NAPS was significantly lower than that before operation in both groups, however, there was no significant difference in the improvement of NAPS between the two groups. CONCLUSION: Percutaneous pedicle screw fixation using mini-invasive pedicle screw system guided by computer navigation is a good surgical therapeutic choice in thoracic-lumbar fracture.