微创经皮经椎弓根螺钉固定治疗胸腰椎骨折的疗效观察

Syed Ahmad Faizan, Muhammad Farooq, Zubair Mustafa Khan, Tariq Imran, Asif Bashir
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摘要

背景与目的:本研究旨在确定经皮经椎弓根螺钉固定(TPSF)治疗胸腰椎骨折的疗效。材料与方法:选取来自拉合尔LGH PINS神经外科的157例胸腰椎骨折患者。通过x线平片、CT和MRI扫描对患者进行评估。术前和术后记录神经系统状况。所有患者均采用微创经皮经椎弓根螺钉固定。通过手术记录获得手术时间和术中出血量数据。术后疼痛的严重程度和住院时间也被记录下来。结果:157例患者中男性占69.4%,女性占30.6%。141例(89.8%)是道路交通事故/跌倒造成的创伤,16例(10.2%)是病理性的。第1天出院128例(81%),第2天出院23例(15%),第3天出院6例(3.8%)。79%的患者有单节段脊柱骨折,而20%的患者有2节段脊柱骨折。MIS经皮TPSF平均手术时间为55分钟。与传统开放手术相比,术后疼痛明显减轻,没有患者出现任何新的神经功能缺损。平均失血量为25ml,术后无患者需要输血。结论:经皮经椎弓根内固定是胸腰椎稳定的理想手术入路。关键词:胸腰椎骨折,经皮椎弓根螺钉固定,微创脊柱手术,道路交通事故。
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The Outcome of Minimally Invasive Percutaneous Transpedicular Screw Fixation (TPSF) in Thoracolumbar Spine Fractures
Background & Objective:  This study aimed to determine the outcome of percutaneous transpedicular screw fixation (TPSF) in patients with thoracolumbar fractures. Material & Methods:  A total of 157 patients with thoracolumbar fractures were included from the Department of Neurosurgery, LGH, PINS, Lahore. Patients were evaluated with plain X-rays, CT, and MRI scans. Neurological status was documented preoperatively and postoperatively. All patients were treated with Minimally Invasive Percutaneous Transpedicular screw fixation. Data for operative time and per-operative blood loss was obtained through the operative notes. The severity of postoperative pain and length of hospital stay were also documented. Results:  Out of 157 patients, 69.4% were male and 30.6% were female. The 141 (89.8%) were traumatic from road traffic accidents/falls, and 16 (10.2%) were pathologic. The 128 (81%) patients were discharged on the first day, 23(15%) were discharged on the second day, and 6(3.8%) on the third day. 79% of patients had a single level of spine fracture whereas, 20% had 2 spinal fracture levels. The average operative time for MIS percutaneous TPSF was 55 minutes. Postoperative pain was markedly reduced as compared to traditional open surgery and no patient had any new neurological deficit. The mean blood loss was 25 ml and none of the patients needed a postoperative blood transfusion. Conclusion:  Percutaneous transpedicular instrumentation is an ideal surgical approach for thoracolumbar spinal stabilization. Keywords:  Thoracolumbar Fractures, Percutaneous Transpedicular Screw Fixation, Minimally Invasive Spine Surgery, Road Traffic Accidents (RTA).
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