光电导航下经皮椎弓根螺钉复位内固定和开放后路椎弓根螺钉复位内固定治疗胸腰椎骨折

发布时间：2018-08-04 19:06

【摘要】：背景:光电导航引导下经皮椎弓根螺钉的植入已在临床中广泛开展,其准确性、安全性、有效性目前仍缺乏循证医学的证实。目的:比较后路光电导航下经皮椎弓根螺钉复位固定术与传统开放手术治疗胸腰椎骨折的临床疗效。方法:61例胸腰椎骨折患者,分别采用光电导航下经皮椎弓根螺钉复位内固定治疗(31例,微创组)和传统开放后路椎弓根螺钉复位内固定(30例,开放组)治疗。对两组患者围手术期相关指标、影像学指标、术后功能恢复情况及并发症发生率并进行比较。结果与结论:(1)微创手术组内固定后1周伤口疼痛评分、术中出血量、X射线透视次数、术后住院时间均显著低于或少于开放组(P0.05);(2)手术时间两组差异无显著性意义(P0.05);(3)两组内固定后椎体复位的影像学指标均较内固定前明显改善(P0.05);两组内固定后影像学指标较内固定改善程度差异无显著性意义(P0.05);(4)术后螺钉与上终板夹角微创组显著小于开放组(P0.05);(5)内固定后微创组优良植钉率显著高于开放组(P0.05);(6)结果说明,光电导航下经皮椎弓根螺钉内固定术治疗胸腰椎骨折与传统开放手术相比具有置钉准确性高、术中透视次数少、切口小、出血少、恢复快等优点。
[Abstract]:Background: percutaneous pedicle screw implantation guided by photoelectric navigation has been widely used in clinical practice. The accuracy, safety and effectiveness of percutaneous pedicle screw implantation are still not confirmed by evidence-based medicine. Objective: to compare the clinical effects of percutaneous pedicle screw reduction and fixation with conventional open surgery in the treatment of thoracolumbar fractures. Methods Sixty-one patients with thoracolumbar fractures were treated by photo-electronic navigation with percutaneous pedicle screw reduction and internal fixation (31 cases, minimally invasive group) and traditional posterior pedicle screw reduction and internal fixation (30 cases, open group). The related indexes, imaging indexes, postoperative functional recovery and incidence of complications were compared between the two groups. Results and conclusion: (1) in the minimally invasive operation group, the wound pain score, the intraoperative bleeding volume and the times of X-ray fluoroscopy were evaluated at 1 week after internal fixation. The postoperative hospitalization time was significantly lower than or less than that in the open group (P0.05); (2) there was no significant difference in the operation time between the two groups (P0.05); (3) the imaging indexes of vertebral body reduction after internal fixation in both groups were significantly improved compared with those before internal fixation (P0.05); There was no significant difference in the degree of improvement between the standard and the internal fixation (P0.05); (4). The rate of excellent nail implantation in the minimally invasive group was significantly lower than that in the open group (P0.05); (5) (P0.05); (6), and that in the open group was significantly higher than that in the open group (P0.05); (6). Compared with the traditional open surgery, the percutaneous pedicle screw internal fixation under photo-electric navigation has the advantages of high accuracy, less fluoroscopy, small incision, less bleeding, and quick recovery compared with the traditional open surgery.
【作者单位】：自贡市第四人民医院骨科;
【基金】：2016自贡市重点科技计划项目(第一批)(2016SFO1)~~
【分类号】：R687.3

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