微创经皮椎弓根螺钉Sextant内固定治疗老年骨质疏松性脊柱骨折的疗效

发布时间：2018-05-27 11:46

  本文选题：椎弓根螺钉 + Sextant内固定　； 参考：《中国老年学杂志》2017年08期

【摘要】：目的探讨微创经皮椎弓根螺钉Sextant内固定治疗老年骨质疏松性脊柱骨折(OVF)的疗效。方法 67例老年OVF患者根据其意愿分为Sextant内固定组(n=35)与开放内固定组(n=32),均获随访24~48 w,比较两组围术期指标及内固定前、内固定后3 d、24 w的病椎前缘高度比值、后凸Cobb角、矢状位指数,并对比两组内固定前、内固定后24 w目测类比评分、Oswestry功能障碍指数(ODI)。结果与开放内固定组相比,Sextant内固定组切口长度、术中失血量、手术时间、住院时间明显减少(P0.05),但术中X线暴露时间明显延长(P0.05)。与本组内固定前相比,两组内固定后3 d、24 w的病椎前缘高度比值、矢状位指数、后凸Cobb角均明显改善(P0.05),而两组固定后3 d、24 w的各指标比较无明显差异(P0.05);两组内固定后24 w的目测类比评分、ODI均明显改善(P0.05),且Sextant内固定组明显优于开放内固定组(P0.05)。Sextant内固定组术后并发症明显少于开放内固定组(P0.05)。结论微创经皮椎弓根螺钉Sextant内固定是治疗老年OVF的一种微创、安全、有效的方法。
[Abstract]:Objective to evaluate the effect of minimally invasive percutaneous pedicle screw (Sextant) internal fixation in the treatment of osteoporotic spinal fracture. Methods Sixty-seven elderly patients with OVF were divided into two groups according to their wishes: Sextant internal fixation group (n = 35) and open internal fixation group (n = 32). All patients were followed up for 24 weeks. The indexes of perioperative period and the ratio of anterior height and kyphosis Cobb angle before and after internal fixation were compared between the two groups. Sagittal index and Oswestry dysfunction index were compared between the two groups before and 24 weeks after internal fixation. Results compared with the open internal fixation group, the incision length, blood loss, operation time and hospital stay in the Sextant internal fixation group were significantly reduced, but the exposure time of X ray during operation was significantly prolonged. The ratio of anterior height and sagittal index of the diseased vertebrae at 3 d and 24 weeks after internal fixation in the two groups were compared with those before internal fixation. The kyphosis Cobb angle was significantly improved in both groups, but there was no significant difference between the two groups in three days and 24 weeks after fixation. The visual analogue scores of 24 weeks after internal fixation were significantly improved in both groups, and the Sextant internal fixation group was significantly better than the open internal fixation group in P0.05.Sextant. The postoperative complications in the internal fixation group were significantly less than that in the open internal fixation group (P 0.05). Conclusion minimally invasive percutaneous pedicle screw Sextant fixation is a minimally invasive, safe and effective method for the treatment of senile OVF.
【作者单位】： 青海省人民医院骨科;
【基金】：青海省2015年卫生计生指导性科研课题(No.青卫科〔2015〕18号)
【分类号】：R687.3;R580
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本文编号：1941949