| 杨智泉,高 东,李耀章,张 伟,李卫勤,白马恒.经皮RTS钉固定与常规椎弓根固定在胸腰段压缩骨折中的疗效比较[J].,2020,(14):2715-2718 |
| 经皮RTS钉固定与常规椎弓根固定在胸腰段压缩骨折中的疗效比较 |
| Comparison of the Clinical Effect of RTS Percutaneous Pedicle Screw Placement and Conventional Pedicle Screws in the Treatment of Thoracolumbar Fractures |
| 投稿时间：2020-01-23 修订日期：2020-02-18 |
| DOI：10.13241/j.cnki.pmb.2020.14.025 |
| 中文关键词: 胸腰椎骨折 RTS 椎弓根螺钉 |
| 英文关键词: Thoracolumbar fractures RTS pedicle screw Pedicle screws |
| 基金项目:国家自然科学基金项目（81702935） |
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| 中文摘要: |
| 摘要 目的：分析和比较使用经皮RTS钉固定与常规椎弓根固定在胸腰段骨折中的临床疗效和安全性。方法：对2017年6月至2018年6月在我院住院，经诊断为胸腰段骨折，且经纳入及排除标准筛选后的共计74例患者进行回顾性分析。根据不同的手术方式和选择，将纳入的患者分为经皮RTS钉固定组（观察组；40例）和常规椎弓根螺钉固定组（对照组；34例）。在术后的3天，1月及1年比较两组患者的疼痛评分及功能评分；并通过其影像学指标（伤椎高度恢复，cobb角恢复等）比较两组的影像学疗效；比较两组患者的手术时间，出血量，切口长度等手术指标；比较两组患者的并发症等情况。结果：在术后3天时，观察组患者的VAS评分显著优于对照组(P<0.05)，而在术后1月及1年时，两组患者未见显著差异(P>0.05)。两组患者的Cobb角及前缘高度百分比较术前均有显著改善(P<0.05)，且两组间均有显著差异(P<0.05)。两组患者在手术时间，切口长度，透视次数，出血量，出院时间等均有显著差异(P<0.05)。两组患者在并发症的比较中并无统计学差异(P>0.05)。结论：与常规的开放椎弓根螺钉固定相比，对于胸腰椎压缩骨折，RTS螺钉能够有效的恢复影像学指标，特别是在前缘高度及Cobb角恢复，并且能够有效地减少创伤及出血，加快功能恢复，在临床中可以进一步推广。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the clinical effect of RTS percutaneous pedicle screw placement and conventional pedicle screws in the Treatment of Thoracolumbar Fractures. Methods: From 2017.06 to 2018.06，74 cases of Thoracolumbar Fractures were divided into two groups according to different operation ways. 40 patients underwent surgery using RTS percutaneous pedicle screw placement (experimental group), while 30 patients underwent surgery with the conventional pedicle screws (control group). The VAS and ODI scores in 3 days, 1 month, 6 months and 12 months after operations, percentage of anterior height of injured vertebrae and Cobb angle before and 1 month, 12 months after operations, blood loss, operation time, hospital stay were analyzed. Results: 3 days after operation, the VAS score of the experimental group was lower than that of control group (P<0.05), while there was no significant difference in 6 months and 12 months after operation (P>0.05). Percentage of anterior height and Cobb angle improved significantly immediately after operation (P<0.05) and there was significant differences between 2 groups (P<0.05). There were significant differences in blood loss, operation time and hospital stay between the two groups(P<0.05). There was no significant difference in the complications between the two groups. Conclusion: Comparing the conventional method, using the RTS percutaneous pedicle screw placement can effective recovery of imaging, especially the anterior edge height of vertebral body and the Cobb angle, effectively reduce the trauma and hemorrhage, speed up the functional recovery, which can further promote in the clinical. |
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