微创(经皮)椎弓根螺钉治疗胸腰椎骨折的选择

Z. Siedlecki, M. Śniegocki
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摘要

介绍。经椎弓根融合的微创技术已经变得非常普遍,似乎取代了传统的开放技术。椎弓根螺钉融合是治疗创伤性腰椎、胸椎不稳定骨折的首选方法。这项研究的目的是回答开放式技术是否仍然用于受伤,或者它们是否已经完全被mis所取代。该手稿介绍了尼古拉斯哥白尼大学比得哥什医学院神经外科、神经创伤学和儿科神经外科2017-2021年治疗的患者的分析。通过对医学文献的分析发现,2017-2021年创伤性胸腰椎骨折病例均采用微创技术治疗。根据该文件,最后一次使用开放性手术技术治疗创伤是在2016年。值得注意的是,经皮技术在胸腰椎骨折的手术治疗中占主导地位,并取代了我科的经典技术,这些技术仅在某些情况下用于治疗非外伤性脊柱滑脱。因此,经皮技术是目前我院脊柱损伤融合术的首选方法。经皮技术的使用减少了手术对组织的创伤(重要的是避免创伤患者的额外创伤和失血)。已经指出,这些手术是由神经外科医生进行的,他们在教学过程中经常使用经皮技术,现在更喜欢这种方法。经皮技术的应用在神经外科护理领域具有重要的意义,因为手术区域的护理包括观察少量(4-16)小伤口,而不是一个长伤口(如经典技术),这些伤口位于钛螺钉尖端的正上方,必须在神经外科护士的护理下。(JNNN 2022; 11 (1): 3 - 7)
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Minimally Invasive (Percutaneous) Pedicle Srews as the Treatment of Choice in Thoracolumbar Spine Fractures
Introduction. Minimally invasive techniques of transpedicular fusion have become very common and seem to displace classical open techniques. Pedicle screws fusion is the procedure of choice in unstable traumatic lumbar and thoracic spine fractures of.Aim. The aim of the study was to answer whether open techniques are still used in injuries or whether they have been completely replaced by MISS.Material and Methods. The manuscript presents an analysis of patients treated in 2017–2021 in the Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery of Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University.Results. Based on the analysis of medical documentation, it was found that every case of traumatic thoracolumbar spine fracture in 2017–2021 was treated using minimally invasive techniques. According to the documentation, the last case of using open surgical technique in the case of trauma was in 2016. It was noted that percutaneous techniques dominated the surgical treatment of thoracolumbar spine fractures and replaced the classic techniques in our department, which are used only, in some cases, in treatment of non-traumatic spondylolisthesis.Conclusions. Therefore, percutaneous techniques are currently the procedure of choice in spine injuries fusion in our hospital. The use of percutaneous techniques reduces the surgical traumatization of tissues (it is important to avoid additional traumatization and blood loss in traumatic patients). It has been pointed out that these procedures are performed by neurosurgeons who, in teaching process, used percutaneous techniques often and now prefer this method. The use of percutaneous techniques has important aspect in the field of neurosurgical nursing, because care of the operated area consists in observing few (4–16) smaller wounds, not one long wound (as in classic techniques), and these wounds are located directly above the titanium screw tips, which must under neurosurgical nurse care. (JNNN 2022;11(1):3–7)
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