微创三节段经皮椎弓根螺钉内固定选择性治疗胸腰椎骨折.docVIP

微创经皮椎弓根螺钉内固定治疗胸腰椎骨折李长青周跃王建初同伟张正丰 摘要目的评价微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的效果。方法2008年月2009年月例胸腰椎骨折分为微创手术组16例男性例，女性例，±8.6）岁手术组例男性例，女性例，42.4±9.3）岁对比分析手术切口、手术时间、出血量以及后凸畸形矫正率等。结果微创手术组手术切口16.5±1.8)、(10.1±1.0) cm，P0.05], 术中出血量346.2±138.7)、(81.3±21.9) ml, P0.01] 及术后引流量138.6±46.5)、(13.7±4.3 ) ml, P0.01]均明显减少，手术时间明显缩短2.5±0.7)、(1.2±0.6) h, P 0.05]。微创手术组手术前后Cobb`s角 (3.8±2.8)°、 (15.4±5.1)°, P0.01]、椎体矢状面指数 (7.3±9.1)°、( 19.7±10.3)°, P0.01] 和伤椎椎体前缘高度(86.4±6.9) %、( 63.2±14.6) %, P0.01] 均显著恢复。结论在严格掌握手术适应证的前提下，微创经皮椎弓根螺钉内固定术是治疗胸腰椎骨折的较好选择。 关键词骨折经皮椎弓根螺钉内固定术percutaneous pedicle screw fixationin thoracolumbar fracture using multi-level Sextant system LI Chang-qing,LUO Gang, ZHOU Yue, WANG Jian, CHU Tong-wei, ZHANG Zheng-feng. Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China Abstract：Objective To assess the therapeutic effect of mini-invasive percutaneous pedicle screw fixation in thoracolumbar fracture using multi-level Sextant system. Methods From June 2008 to March 2009, 42 thoracolumbar fracture patients in our department were selected. They were divided into two groups: 16 cases (11 males and 5 females, age 40.2±8.6) were included in the multi-level Sextant percutaneous pedicle screw fixation group and 26 cases（17 males and 9 females, age 42.4±9.3）were in the open pedicle screw fixation group. The incision size, surgical time, surgical blood loss, correction rate of kyphosis of the two groups were compared. Results Compared with the open pedicle screw fixation group, patients in the multi-level Sextant percutaneous pedicle screw fixation group experienced a significantly smaller incision size（.1±1.0 cm vs. 16.5±1.8 cm, P0.05）, a significant decrease in surgical blood loss (8.3±21.9 ml vs.346.2±138.7 ml, P0.01) and surgical draining loss (13.7±4.3 ml vs.138.6±46.5 ml, P0.01). Surgical time shortened significantly (1.2±0.6 h vs.2.5±0.7 h, P 0.05). There were significant postoperative improvement in Cobb`s angle (3.8±2.8° vs. 15.4±5.1°, P0.01),