Ye Hui, Chen Qi-Xin
Department of Orthopaedics, the Second Affiliated Hospital of Medical College of Zhejiang University, Hangzhou 310003, Zhejiang, China;
Department of Orthopaedics, the Second Affiliated Hospital of Medical College of Zhejiang University, Hangzhou 310003, Zhejiang, China.
Zhongguo Gu Shang. 2017 Feb 25;30(2):105-109. doi: 10.3969/j.issn.1003-0034.2017.02.003.
To compare the clinical outcomes of minimally invasive percutaneous pedicle screw fixation and open surgery in the treatment of thoracolumbar fracture.
A retrospective study of patients who had undergone surgery for thoracolumbar fracture from June 2014 to December 2014 was performed. Sixty-one cases were included and 29 cases were treated by minimally invasive percutaneous pedicle screw fixation (minimally invasive group) and 32 cases were treated by the traditional open pedicle screw fixation(open group). The differences in the total length of the incision, intraoperative fluoroscopy times, operative time, blood loss, the preoperative and postoperative visual analogue scale(VAS), postoperative bedridden time and hospital stay were compared. And the preoperative and postoperative anterior vertebral body height and Cobb angle of the kyphosis were also compared.
Compared with the open group, the total length of incision was smaller and intraoperative blood loss was less, bedridden time and hospital stay were shorter, and pain of the wound was less in the minimally invasive group. Postoperatively, the anterior vertebral body height was retorted and the Cobb angle of the kyphosis was corrected obviously in both groups. But no significant difference in the imaging results was found between two groups(>0.05).
Minimally invasive percutaneous pedicle screw fixation has the similar fixation efficacy with open surgery in treating thoracolumbar fracture. However, it can avoid extensive muscle stripping, and obviously reduce the surgical incision, operative time, postoperative pain, bedridden time and hospital stay. According to the clinical efficacy, it is worthy of clinical application.
比较微创经皮椎弓根螺钉内固定术与开放手术治疗胸腰椎骨折的临床疗效。
对2014年6月至2014年12月接受胸腰椎骨折手术治疗的患者进行回顾性研究。纳入61例患者,其中29例采用微创经皮椎弓根螺钉内固定术治疗(微创组),32例采用传统开放椎弓根螺钉内固定术治疗(开放组)。比较两组手术切口总长度、术中透视次数、手术时间、出血量、术前及术后视觉模拟评分(VAS)、术后卧床时间及住院时间。同时比较两组术前及术后椎体前缘高度和后凸Cobb角。
与开放组相比,微创组手术切口总长度更小、术中出血量更少、卧床时间及住院时间更短,伤口疼痛更轻。术后两组椎体前缘高度均有恢复,后凸Cobb角均明显矫正,但两组影像学结果差异无统计学意义(P>0.05)。
微创经皮椎弓根螺钉内固定术在治疗胸腰椎骨折方面与开放手术具有相似的固定效果。然而,它可避免广泛的肌肉剥离,明显减少手术切口、手术时间、术后疼痛、卧床时间及住院时间。根据临床疗效,值得临床应用。