经皮与开放椎弓根钉内固定治疗无神经损伤胸腰椎骨折的回顾性研究

目的比较经皮和开放椎弓根钉内固定治疗无神经损伤胸腰椎骨折的疗效。方法回顾性分析自2012-03—2015-09诊治的105例胸腰椎骨折,采用经皮椎弓根钉内固定治疗56例(微创组),采用开放椎弓根钉内固定治疗49例(开放组)。比较2组手术时间、术中出血量、术后引流量、住院时间,以及术后3 d、6个月、末次随访时的VAS评分、Cobb角、椎体楔角、椎体前缘高度比值。结果微创组获得(22.5±4.4)个月随访,开放组获得(23.0±4.3)个月随访。与开放组比较,微创组手术时间、住院时间更短,术中出血量、术后引流量更少,差异有统计学意义(P0.05)。术后3 d、6个月时微创组VAS评分低于开放组,差异有统计学意义(P0.05)。末次随访时2组VAS评分、Cobb角、椎体楔角、椎体前缘高度比值差异无统计学意义(P0.05)。结论经皮椎弓根钉内固定治疗无神经损伤胸腰椎骨折疗效满意,具有软组织损伤小、术中失血少、术后恢复快的优点,并且手术安全可靠。

A retrospective study on pertacuneous and open pedicle screw fixation for traumatic thoracolumbar fractures without neurological deficits

Objective To compare the clinical effect of percutaneous and open transpedicle screw fixation on thoracolumbar vertebral fractures without neurological deficit.Methods A retrospective analysis of 105 patients with thoracolumbar vertebral fractures treated in our hospital from Mar.2012 to Sept.2015 was performed.Fifty six patients treated with percutaneous transpedicle screw fixation were included in minimally invasive group while 49 patients treated with open transpedicle screw fixation were regarded as open group.The operation time,intraoperative blood loss,post-operation drainage,hospital stays,and VAS score of 3rd days,6 months after operation and the latest follow-up,Cobb angle,vertebral body wedge angle,anterior height ratio of vertebrae were compared.Results The minimally invasive group was followed up (22.5±4.4) for a month,while the open group got (23.0±4.3)months follow-up.Compared with the open group,the operation time and hospital stay were shorter,and intraoperative blood loss and post-operation drainage were less in the minimally invasive group,the differences were statistically significant(P ＜0.05).VAS score of 3rd days,6 months after operation in minimally invasive group was lower than that in open group,the difference was statistically significant (P ＜0.05).There were no statistically significant differences in the VAS score of the last follow-up,Cobb angle,vertebral body wedge angle,anterior height ratio of vertebrae (P ＞0.05).Conclusion The clinical effect of percutaneous transpedicle screw fixation on thoracolumbar vertebral fractures without neurological deficit is satisfying,there are advantages of little soft tissue injury,less intraoperative blood loss,quicker postoperative recovery.What's more,the operation is safe and practicable.