【摘要】 目的探讨经皮微创治疗胸腰椎骨折伴后方韧带复合体损伤的安全性与有效性,为短节段经皮微创治疗方法的应用提供参考。方法选取2012年9月到2016年1月我院骨科诊治的94例伴后方韧带复合体损伤的胸腰椎骨折患者,根据不同手术方法分为观察组与对照组,每组47例。观察组选择后路短节段经皮微创椎弓根钉内固定治疗,对照组选择后路单节段经皮微创椎弓根钉内固定,记录2组预后情况。结果 2组患者手术时间、术中出血量对比差异无明显统计学意义(P>0.05),观察组术后引流量与术后住院时间少于对照组,差异有统计学意义(P<0.05)。观察组术后1个月的JOA评分状况优于对照组,差异有统计学意义(P<0.05)。观察组术后1个月椎弓根螺钉断裂、椎弓根螺钉松动、切口感染、肺部感染等并发症发生率为4.3%,对照组为21.3%,观察组少于对照组,差异有统计学意义(P<0.05)。术后1个月观察组与对照组的后凸Cobb’s角分别为(8.55±1.34)°和(16.30±2.33)°,都低于术前的(32.19±1.98)°和(32.08±2.08)°,手术前后比较,差异有统计学意义(P<0.05),同时观察组术后Cobb’s角也低于对照组,差异有统计学意义(P<0.05)。结论短节段经皮微创治疗伴后方韧带复合体损伤的胸腰椎骨折能减少术后并发症的发生,矫正后凸畸形,促进神经功能的恢复,具有更好的安全性与有效性。更多还原

【Abstract】 Objective To investigate the efficacy and safety of the minimally invasive percutaneous surgery in the treatment of thoracolumbar fracture combined with posterior ligament injury. Methods The 94 cases of thoracolumbar fracture combined with posterior ligament injury who were admitted into our hospital from September 2012 to January 2016 were selected and equally divided into the observation group and the control group( 47 cases in each group) according to different methods. Patients of the observation group were treated with short segment of minimally invasive percutaneous surgery,while patients of the control group were underwent single segment of minimally invasive percutaneous surgery. Recorded the outcomes and prognosis of the two groups. Results There was no significant difference in the operation time and blood loss between the two groups( P > 0. 05). The postoperative volume of drainage and the length of stay in the observation group were significantly shorter than those in the control group( P < 0. 05). The JOA score of the observation group 1 month after operation was significantly better than that of the control group( P < 0. 05). The incidence of complications including pedicle screw breakage,pedicle screw loosening,incision infection,and pulmonary infection in the observation group was 4. 3%,which was significantly less than 21. 3% in control group( P < 0. 05). The Cobb’s angle of the obervation group and control group 1 month after operation were( 8. 55 ± 1. 34) ° and( 16. 30 ±2. 33) ° respectively,which were significantly lower than( 32. 19 ± 1. 98) ° and( 32. 08 ± 2. 08) ° before operation( P < 0. 05). And the Cobb’s angle 1 month after operation in the observation group were significantly lower than that of the control group( P < 0. 05). Conclusion The short segment of minimally invasive percutaneous surgery for the treatment of thoracolumbar fracture combined with posterior ligament injury can reduce the incidence of postoperative complications,promote the patient’s rehabilitation,correct the kyphosis and promote the recovery of neural function,which was safer and more efficient.更多还原