经皮长尾可折U形空心椎弓根钉系统固定治疗胸腰椎骨折的疗效评估

Effect of the long percutaneous U-shaped hollow pedicle screw systems for thoracolumbar fracture

中文关键词:  长尾可折U形空心椎弓根钉系统  微创  内固定  胸腰椎骨折

英文关键词:Long U-shaped hollow pedicle screw systems  Percutaneous transpedicular  Internal fixation method  Thoracolumbar fracture

中文摘要:

  【摘要】 目的：评价经皮长尾可折U形空心椎弓根钉系统内固定治疗胸腰椎骨折的临床疗效。方法：选择2009年1月～2010年8月无明显神经损伤的不稳定胸腰椎骨折患者80例，分A组（长尾可折U形空心椎弓根钉系统内固定），B组（常规开放椎弓根钉固定），比较两组的手术切口长度、手术时间、术中出血量、术后切口引流量以及手术前后伤椎椎弓前缘高度、矢状面Cobb角、椎管骨块占位率、置钉优良率以及术后3、6、12个月随访比较椎体高度、Cobb角及腰痛情况等。结果：两组手术时间、术中出血量、术后切口渗血及切口总长度A组分别为90.18±17.39min、81.25±8.67ml、6.60±1.64ml及6.86±0.60cm；B组分别为116.95±16.18min、315.70±72ml、224.48±30.18ml及13.53±1.48cm。以上各指标A、B两组有明显差异（P＜0.05）。术后椎体前缘高度、Cobbs角、椎管骨块占位率及置钉优良率A组分别为（93.83±4.20）％、4.28°±1.08°、（3.49±3.27）％及96.25％；B组分别为（94.31±3.12）％、3.95°±0.97°、（3.27±3.03）％及97.50％，以上指标两组比较差异没有显著性（P＞0.05）；术后3、6、12个月随访影像学指征两组间无显著差异（P＞0.05）。结论：经皮长尾可折U形空心椎弓根钉具有创伤小、操作方便、复位固定及效果与常规椎弓根钉固定一致，值得临床推广应用。

英文摘要:

  【Abstract】 Objectives: To evaluate the surgical outcome of long percutaneous U-shaped hollow pedicle screw systems for thoracolumbar fractures. Methods: 80 cases suffering from unstable thoracolumbar fractures while without obvious neurologic deficits from January 2009 to August 2010 were reviewed retrospectively. All cases were divided into two groups: group A (long percutaneous U-shaped hollow pedicle screw systems), group B (conventional transpedicular pedicle screw systems). The skin incision length, operative time, intraoperative and postoperative blood loss, anterior vertebral body height, sagittal Cobb angle, narrowing rate of vertebral canal, the screw position, and back pain before and 3、6、12 months after operation between two groups were compared. Results: In group A, the operative time was 90.18±17.39min, intraoperative blood loss was 81.25±8.67ml, postoperative blood loss was 6.60±1.64 ml and the total length of skin incision was 6.86±0.6cm; while in group B, the data were 116.95±16.18min, 315.70±72ml, 224.48±30.18ml and 13.53±1.48cm respectively, which showed significant difference between two groups(P<0.05). The postoperative anterior vertebral body height in group A was 93.83±4.20％, the Cobb angle was 4.28±1.08°，the narrowing rate of vertebral canal was 3.49±3.27％ and a total of 96.25％ screws were in good position; while in group B, which were 94.31±3.12％，3.95±0.97°，3.27±3.03％ and 97.50％respectively, which showed no significant difference between two groups(P＞0.05). No significant difference existed with respect to image finding between two groups(Ｐ＞0.05). Conclusions: Long percutaneous U-shaped hollow pedicle screw system is reliable with minimal invasiveness, which is comparable to the conventional pedicle screw instrument.