微创经皮与传统开放椎弓根螺钉内固定治疗胸腰椎骨折的疗效对比.doc

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1、微创经皮与传统开放椎弓根螺钉内固定治疗胸腰椎骨折的疗效对比［摘要］目的对比微创经皮与传统开放椎弓根螺钉内固定治疗胸腰椎骨折的疗效。方法选择2012年7月一2014年7月于我院收治并行手术治疗的单纯胸腰椎骨折患者56例，微创组患者30例，则采用微创经皮椎弓根螺钉固定术。开放组患者26例，采用传统的开放椎弓根螺钉内固定术，观察并比较两组患者手术时间，术中出血量、切口长度、术后VAS评分。分别对术前及术后对两组患者Cobb角、椎体前缘高度百分比、0DI指数进行统计比较。结果微创组手术吋间、术中出血量、切口长度、术后VAS评分均优于开放组，差异具有统计学

2、意义(p<0.05)o两组术前与术后同组Cobb角、伤椎椎体前缘高度百分比、0DI指数比较差异均有统计学意义(P<0.05)。两组术后Cobb角、伤椎椎体前缘高度百分比、0DI指数比较,差异均无统计学意义(p>；0.05)o结论微创经皮椎弓根螺钉内固定术与传统开放椎弓根内固定术治疗胸腰椎骨折疗效都能取得较好的临床效果且效果相当，但前者具有创伤小、操作简便、手术时间短、术中出血少、术后恢复快等优势，值得临床推广，但远期疗效尚需进一步随访观察。［关键词］微创经皮；椎弓根内固定；胸腰椎骨折Effectcomparisionofminim

3、allyinvasivepercutaneousandtraditionalopentreatmentforthoracolumbarfractureswithpediclescrewsystemObjective:Tocomparetheclinicaleffectbetweenminimallyinvasivepercutaneousandtraditionalopenpediclescrewfixationinthetreatmentofthoracolumbarfracture.Methods:FromJuly2012toJuly2014

4、,fifty-sixpatientsinourdepartmentwithnoneurologicalsymptomsofthoracolumbarfracturewereineludedinthisretrospectivestudy・30patientsweretreatedwithminimallyinvasivepercutaneouspediclescrewfixationand26caseswiththetraditionalopenpediclescrewfixation.Aseriesofindincesincludingtheo

5、perativetime,bloodloss,lengthofincision,pre—andpost—operativeVAS(visualanaloguescale)scorewereobserved.TheCobbangle,ODI(Oswestrydisabilityindex)aswellasanteriorheightofthefracturevertebralbodywereevaluated・Results:Thereweresign讦icantdifferences(P<0.05)intheincisionsize,surgic

6、albloodloss,surgicaltimeandpost-operationVASscore.TheCobbangle,ODI,andanteriorheightofthefracturevertebralbodywereallsign讦icantlydifferentbetweenpre-operationandpost-operationineachgroup(P<0.05).TherewasnosignificantdiffereneeinpostoperativeimprovementofCobbangle,ODI,anterior

7、heightofthefracturevertebralbodyinthetwogroups(P>0.05).Conclusions:Minimallyinvasivepercutaneouspediclescrewfixationisaneffectivemethodtotreatthoracolumbarfracture.Thisprocedureissimpler,safer,lesscomplication,quickerrecoveryandbloodlossthanopenoperation.Keywords:minimallyinv

8、asivepercutaneous;pediclescrewfixation;thoracolumbarfractures胸腰椎骨折约占