| 赖宇锐.两种不同手术方式治疗无神经损伤胸腰椎骨折的疗效及安全性对比[J].浙江中西医结合杂志,2017,27(10): |
| 两种不同手术方式治疗无神经损伤胸腰椎骨折的疗效及安全性对比 |
| Comparison of the efficacy and safety of two different surgical methods in the treatment of thoracolumbar fractures without nerve injury |
| 投稿时间：2017-04-25 修订日期：2017-06-21 |
| DOI： |
| 中文关键词: 经皮椎弓根钉内固定 切开复位椎弓根钉内固定 胸腰椎骨折 疗效 安全性 |
| 英文关键词:percutaneous pedicle screw fixation open reduction and fixation with pedicle instrumentation thoracolumbar fracture curative effect safety |
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| 中文摘要: |
| 目的 探讨微创经皮椎弓根螺钉内固定与传统开放置钉治疗无神经损伤性胸腰椎骨折的疗效及安全性。方法 将本院于2015年4月至2016年4月收治的100例无神经损伤性胸腰椎骨折患者纳入本研究，根据手术方式的不同分为实验组（微创经皮置钉，53例）和对照组 (开放置钉，47例)。术后随访12个月，比较两组的手术情况、腰部疼痛视觉模拟(visual analogue scale, VAS) 评分、Cobb 角、置钉位置等。结果 实验组患者的手术切口长度（t=4.03，P<0.01）、术中出血量（t=4.03，P=0.04）、手术时间（t=4.39，P<0.01）、术后下地时间（t=20.55，P<0.01）均明显短(少)于对照组,差异具有统计学意义。与术前比较，两组患者术后1 周及末次随访时的伤椎前缘高度均增加，而Cobb 角均减小，具有统计学差异 (P<0.05)。术后1 周，实验组患者的VAS 评分明显低于对照组,差异有统计学意义(t=7.89,P<0.01)。两组患者的置钉优良率比较无明显差异(χ2=0.12，P=0.73)。结论 对于无神经损伤性胸腰椎骨折患者，应用微创经皮椎弓根螺钉内固定术的疗效良好，安全性高。 |
| 英文摘要: |
| Objective To investigate the efficacy and safety of minimally invasive percutaneous pedicle screw fixation and traditional open fixation for the treatment of thoracolumbar fractures without nerve injury. Method 100 cases of patients with thoracolumbar fractures without nerve injury treated in our hospital from April 2015 to April 2016 were divided into the experimental group (minimal-invasive percutaneous nailing, 53 cases) and the control group (open screws, 47 cases). All patients were followed up for 12 months, and the operation condition, waist visual analogue scale (VAS) score, Cobb′s angle, position of the nail were compared between the two groups. Result The incision length (t=4.03, P<0.01), the amount of bleeding (t=4.03, P=0.04), operation time (t=4.39, P<0.01), postoperative ambulation time (t=20.55, P<0.01) of the patients in the experimental group were significantly shorter (less) than the control group, the difference was statistically significant. Compared with preoperative, the height of anterior edge of vertebral body and the Cobb′s angle significantly improved in postoperative 1 week and the last follow-up(P<0.05). After 1 weeks, the VAS score of the experimental group was significantly lower than that of the control group, the difference was statistically significant (t=7.89, P<0.01). There was no significant difference between the two groups in the rate of nail fixation (χ2=0.12, P=0.73). Conclusion Minimally invasive percutaneous pedicle screw fixation is effective and safe in the treatment of thoracolumbar fractures without nerve injury. |
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