Gong Yahui, Fu Guangmin, Li Bo, Li Yinan, Yang Xiaoning
Department of Orthopedics, The First People's Hospital Xuzhou, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, P.R. China.
Exp Ther Med. 2017 Nov;14(5):4091-4096. doi: 10.3892/etm.2017.5036. Epub 2017 Aug 25.
We compared the clinical effects of minimally invasive percutaneous pedicle screws osteosynthesis (MIPPSO) and open surgery on the repair of thoracolumbar vertebra fracture. Seventy patients, who suffered from thoracolumbar vertebra fracture and received treatment at our hospital, were selected and randomly divided into either the minimally invasive percutaneous pedicle screws osteosynthesis group (MIPPSO group) and the traditional open pedicle screws osteosynthesis group (TOPSO group) with 35 cases in each group. The perioperative parameters including length of incision, duration of operation, bleeding during operation, length of hospital stay, the changes of pre-operative and post-operative VAS pain scores, inflammatory indexes including serum C-reactive protein (CRP) and creatine kinase (CK), and imaging indexes including Cobb's angle and anterior margin height of vertebral body of both groups were compared. The length of incision, duration of operation, bleeding volume during operation and length of hospital stay in the MIPPSO group were significantly lower than those in the TOPSO group (P<0.05). Both minimally invasive surgery and traditional surgery effectively alleviated the pain (P<0.05), which was more significant in MIPPSO group (P<0.05). The post-operative inflammatory indexes, CRP and CK levels, of both groups were higher compared to the pre-operation (P<0.05), which was more significant in TOPSO group (P<0.05). The differences of imaging indexes, including Cobb's angle and anterior margin height of injured vertebra, were statistically significant between pre-operation and post-operation for each group (P<0.05); however, there were no statistically significant differences between two groups at either pre-operation or post-operation (P>0.05). The effect of minimally invasive percutaneous pedicle screws osteosynthesis is similar to the traditional open surgery, however, the MIPPSO technique has the advantages of small trauma, less bleeding, short duration of operation, rapid post-operative recovery, light pain, less economic cost, and better aesthetic effect and is therefore worthy of clinical promotion.
我们比较了微创经皮椎弓根螺钉内固定术(MIPPSO)与开放手术修复胸腰椎骨折的临床效果。选取我院收治的70例胸腰椎骨折患者,随机分为微创经皮椎弓根螺钉内固定组(MIPPSO组)和传统开放椎弓根螺钉内固定组(TOPSO组),每组35例。比较两组患者的手术切口长度、手术时间、术中出血量住院时间等围手术期参数,术前、术后视觉模拟评分法(VAS)疼痛评分的变化,血清C反应蛋白(CRP)、肌酸激酶(CK)等炎症指标,以及Cobb角、椎体前缘高度等影像学指标。MIPPSO组的手术切口长度、手术时间、术中出血量及住院时间均明显低于TOPSO组(P<0.05)。微创和传统手术均能有效缓解疼痛(P<0.05),MIPPSO组更显著(P<0.05)。两组术后炎症指标CRP和CK水平均高于术前(P<0.05),TOPSO组更显著(P<0.05)。每组术前和术后影像学指标(包括受伤椎体的Cobb角和前缘高度)差异有统计学意义(P<0.05);然而,两组术前和术后均无统计学差异(P>0.05)。微创经皮椎弓根螺钉内固定术的效果与传统开放手术相似,但MIPPSO技术具有创伤小、出血少、手术时间短、术后恢复快、疼痛轻、经济成本低、美容效果好等优点,值得临床推广。