六分仪微创经皮椎弓根螺钉内固定与开放式椎弓根螺钉内固定治疗胸腰椎多发骨折的疗效观察

Tongle Yuan, Xiao-ming Zhang
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摘要

目的比较六分仪微创经皮椎弓根螺钉内固定与开放式椎弓根螺钉内固定治疗胸腰椎多发骨折的疗效。方法回顾性分析2016年1月至2018年12月郑州市心血管医院收治的50例胸腰椎多发骨折患者的临床资料。根据手术方式分为微创组(28例)和开放组(22例)。微创组采用六分仪微创经皮椎弓根螺钉固定,开放组采用开放式椎弓根螺钉固定。比较两组患者的手术相关指标(手术时间、术中出血量、切口长度、术后引流量、住院时间)、视觉模拟评分(VAS)评估疼痛状态、Oswestry失能指数(ODI)评估椎体功能、椎体前缘高度、Cobbs角、血清肌酸激酶活性。随访6个月,比较两组患者并发症发生情况。结果微创组术中出血量、切口长度、术后引流量、住院时间均显著少于开放组(P < 0.05)。结论与开放手术相比,六分仪微创经皮椎弓根螺钉固定胸腰椎多发骨折创伤小,可减少失血量,缩短住院时间。有利于损伤椎体高度的恢复。关键词:胸腰椎多发骨折;六分仪微创经皮椎弓根螺钉固定术;开放式椎弓根螺钉固定
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Curative effects of Sextant minimally invasive percutaneous pedicle screw fixation and open pedicle screw fixation on thoracolumbar multiple spine fractures
Objective To compare the curative effects of Sextant minimally invasive percutaneous pedicle screw fixation and open pedicle screw fixation on thoracolumbar multiple spine fractures. Methods A retrospective analysis was performed on clinical data from 50 patients with thoracolumbar multiple spine fractures who were admitted to Zhengzhou Cardiovascular Hospital from January 2016 to December 2018. They were divided into minimally invasive group (28 cases) and open group (22 cases) according to surgical methods. The minimally invasive group was given Sextant minimally invasive percutaneous pedicle screw fixation, while the open group was given open pedicle screw fixation. The related indexes of surgery (operating time, intraoperative blood loss, incision length, postoperative drainage volume, hospital stay), pain status evaluated by visual analogue scale (VAS) score, vertebral function assessed by Oswestry disability index (ODI), height of vertebral anterior margin, Cobbs angle, and activity of serum creatine kinase were compared between the two groups. All patients were followed up for 6 months, and the complications were compared between the two groups. Results The intraoperative blood loss, incision length, postoperative drainage volume and hospital stay in minimally invasive group were significantly less than those in open group (all P 0.05. Conclusions Compared with open surgery, the trauma of Sextant minimally invasive percutaneous pedicle screw fixation is less for patients with thoracolumbar multiple spine fractures, which can reduce blood loss and shorten hospital stay. And it is conducive to recovery of injured vertebrae height. Key words: Thoracolumbar multiple spine fracture; Sextant minimally invasive percutaneous pedicle screw fixation; Open pedicle screw fixation
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