| 刘鹏军 韩康 杨智泉 李卫勤 周勇 刘宏伟.经皮与开放手术椎体椎弓根固定术治疗多椎体压缩性骨折的临床疗效比较[J].,2017,17(7):1251-1254 |
| 经皮与开放手术椎体椎弓根固定术治疗多椎体压缩性骨折的临床疗效比较 |
| Comparison of the Clinical Efficacy of Percutaneous Pedicle Fixation orOpen Operation in the Treatment of Multiple-level Thoracolumbar Fracture |
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| DOI： |
| 中文关键词: 胸腰椎 椎弓根内固定系统 多节段 骨折 |
| 英文关键词: Thoracolumbar spine Pedicle screw fixation system Multiple-level Fracture |
| 基金项目:国家自然科学基金项目(81272441)；济南军区总医院院长基金项目(2015ZX01) |
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| 中文摘要: |
| 目的：研究和比较经皮椎体椎弓根固定术与开放手术治疗多椎体压缩性骨折的临床疗效及安全指标。方法：回顾性分析我
科自2013.06 至2015.06 诊断为多椎体压缩性骨折并行内固定外科手术治疗的共计56例患者。根据手术方法的不同，分为实验
组（经皮椎弓根固定组，32 例）和对照组（开放手术固定组，24 例）。对患者在术前即术后的各项临床指标进行随访和统计，对其
VAS 疼痛指标、JOA 功能评分及患椎的前缘高度比进行比较。并比较两组患者的切口愈合，内固定松动等并发症。并比较两组患
者的手术时间，出血量、下地时间等围手术期指标。结果：本次研究结果显示：经皮和开放椎体椎弓根固定术治疗的患者在术后及
6 月，12 月的VAS 及JOA 评分中均获得了良好的改善，且两组之间并无统计学差异。在椎体前缘高度比值的比较中，术后开放组
优于经皮固定组，但两者之间并无统计学差异。在并发症的比较中，经皮固定组显著优于开放手术组。在围手术期指标的比较中，
经皮手术组在手术时间，出血量，下地时间等指标中都显著优于开放手术组。结论：对于多椎体压缩性骨折，经皮椎体椎弓根固定
术能够达到与开放手术相似的临床治疗效果，但能够有效的减少并发症，并在手术时间，出血量，下地时间等指标中充分体现微
创手术的优势。在多椎体骨折的治疗中可以进一步的进行推广。 |
| 英文摘要: |
| Objective:To compare the clinical effect and safety of percutaneous pedicle fixation or open operation in the treatment
of multiple-level thoracolumbar fracture.Methods:56 cases of patients with multiple-level thoracolumbar fracture treated from 2013.06
to 2015.06 were retrospectively reviewed, in which 32 patients were treated by percutaneous pedicle fixation and 24 patients were treated
by open operation of pedicle fixation. The clinical outcomes were evaluated and compared by operation time, blood loss, stay time and
intraoperative complications. The surgical results were evaluated according to the Visual Analogue Scale(VAS), Japanese Orthopedie association(
JOA) and anterior vertebra height.Results:There was no significant difference between the two groups(experiment group and
control group) in the VAS score and JOA in 6 and 12 months after the operation (P>0.05) although there were significant improvement
comparing with pre-operation (P<0.05). The anterior vertebra height was better in open operation group, however, there was no significant
difference between the two groups (P>0.05). The blood lost, operation time and the stay time in experiment group were significant
better than that in control group. (P<0.05); The complication incidence in experiment group was significant better than that in control
group (P<0.05).Conclusion:For the treatment of multiple-level thoracolumbar fracture, percutaneous pedicle fixation could have the
similar clinical efficacy comparing with the open operation, which could have the less blood loss, operation time, stay time and the complication.
This treatment could be further recommended clinically. |
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