经皮和开放经肌间隙椎弓根螺钉非融合固定治疗无神经功能障碍A<sub>3</sub>/A<sub>4</sub>型胸腰椎骨折的疗效比较

doi:10.3969/j.issn.1671-7171.2023.06.002

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摘要【目的】探讨经皮和开放经肌间隙椎弓根螺钉非融合固定治疗无神经功能障碍的A₃/A₄型胸腰椎骨折的临床疗效。【方法】采用前瞻性队列研究设计,选取2018年1月至2020年12月联勤保障部队第九〇〇医院收治的46例无神经功能障碍A₃/A₄型胸腰椎骨折患者,将患者随机交替纳入经皮椎弓根螺钉固定(transmuscular space screwfixation,PPSF)组和切开经肌间隙椎弓根螺钉固定(Open transmuscular space pedicle screwfixation, OPSF)组。比较两组手术前后Cobb角、12个月后的矫正角丢失、失血量、手术时间、累积辐射时间。【结果】 OPSF组和PPSF组手术前后Cobb角以及12个月后的矫正角丢失比较,差异无统计学意义(P>0.05)。与OPSF组比较,PPSF组手术时间更短,围术期失血量也更少,平均累积辐射时间更长,差异均有统计学意义(P<0.05)。【结论】经皮和切开经肌间隙椎弓根螺钉固定治疗无神经功能障碍A₃/A₄型胸腰椎骨折疗效相当,但经皮椎弓根螺钉固定手术时间更短,失血量也更少,但平均累积辐射时间更长。

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	林楷丰
	钟朕晔
	陈金水
	魏梅洋

关键词 ：脊柱骨折/外科学, 腰椎/外科学, 胸椎/外科学, 骨折固定术, 治疗结果

Abstract：【Objective】 To explore the clinical efficacy of percutaneous and open intramuscular pedicle screw non fusion fixation in the treatment of A₃/A₄ type thoracolumbar fractures without neurological dysfunction. 【Methods】 A prospective Cohort study design was used to select 46 patients with A₃/A₄ thoracolumbar fractures without neurological dysfunction who were admitted to The 900th Hospital of Joint Logistics Support Force from January 2018 to December 2020. The patients were randomly and alternately included in the transmuscular space screwfixation (PPSF) group and the open transmuscular space pedicle screwfixation(OPSF) group. The Cobb angle before and after surgery,corrected loss,blood loss,surgical time,and cumulative radiation time after 12 months were compared between two groups.【Results】 There was no statistically significant difference in Cobb angle before and after surgery and correction loss after 12 months between the OPSF group and the PPSF group (P>0.05). Compared with the OPSF group,the PPSF group had shorter surgical time,less perioperative blood loss,and higher average cumulative radiation time,with statistically significant differences (P<0.05). 【Conclusion】 The efficacy of percutaneous and open intramuscular pedicle screw fixation in the treatment of A₃/A₄ type thoracolumbar fractures without neurological dysfunction is equivalent,but pedicle screw fixation has shorter surgical time,less blood loss,and higher average cumulative radiation time.

Key words： Spinal Fractures/SU Lumbar Vertebrae/SU Thoracic Vertebrae/SU Fracture Fixation Treatment Outcome

收稿日期: 2022-11-07

中图分类号:

R683.2

基金资助:福建省自然科学基金资助项目(编号:2019J01519)

引用本文:

林楷丰, 钟朕晔, 陈金水, 魏梅洋. 经皮和开放经肌间隙椎弓根螺钉非融合固定治疗无神经功能障碍A₃/A₄型胸腰椎骨折的疗效比较[J]. 医学临床研究, 2023, 40(6): 805-807.
LIN Kai-feng, ZHONG Zhen-ye, CHEN Jin-shui, et al. Comparison of Therapeutic Effects between Percutaneous and Open Intramuscular Pedicle Screw Non Fusion Fixation for the Treatment of A₃/A₄ Type Thoracolumbar Fractures without Neurological Dysfunction. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 805-807.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.06.002 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I6/805

[1] HU R,MUSTARD C A,BURNS C. Epidemiology of incident spinal fracture in a complete population[J].Spine (Phila Pa 1976),1996,21(4):492-499.
[2] AZIMI P,MOHAMMADI H R,AZHARI S,et al. The AOSpine thoracolumbar spine injury classification system:A reliability and agreement study[J].Asian J Neurosurg,2015,10(4):282-285.
[3] DAULEAC C,BEURIAT P A,DI ROCCO F,et al. Surgical management of pediatric spine trauma:12 years of experience[J].World Neurosurg,2019,126:e1494-e1502.
[4] HAMILTON K,JOSIAH D T,TIERNEY M,et al. Surgical practice in traumatic spinal fracture treatment with regard to the subaxial cervical injury classification and severity and the thoracolumbar injury classification and severity systems:a review of 58 patients at the university of wisconsin[J].World Neurosurg,2019,127:e101-e107.
[5] WANG H,ZHOU Y,LI C,et al. Comparison of open versus percutaneous pedicle screw fixation using the sextant system in the treatment of traumatic thoracolumbar fractures[J].Clin Spine Surg,2017,30(3):E239-E246.
[6] PHAN K,RAO P J,MOBBS R J. Percutaneous versus open pedicle screw fixation for treatment of thoracolumbar fractures:Systematic review and meta-analysis of comparative studies[J]. Clin Neurol Neurosurg,2015,135:85-92.
[7] KUMAR A,AUJLA R,LEE C. The management of thoracolumbar burst fractures:a prospective study between conservative management,traditional open spinal surgery and minimally interventional spinal surgery[J].Springerplus,2015,4:204.
[8] KIM D Y,LEE S H,CHUNG S K,et al. Comparison of multifidus muscle atrophy and trunk extension muscle strength:percutaneous versus open pedicle screw fixation[J].Spine (Phila Pa 1976),2005,30(1):123-129.
[9] WILD M H,GLEES M,PLIESCHNEGGER C,et al. Five-year follow-up examination after purely minimally invasive posterior stabilization of thoracolumbar fractures:a comparison of minimally invasive percutaneously and conventionally open treated patients[J].Arch Orthop Trauma Surg,2007,127(5):335-343.
[10] LEE J K,JANG J W,KIM T W,et al. Percutaneous short-segment pedicle screw placement without fusion in the treatment of thoracolumbar burst fractures:is it effective? comparative study with open short-segment pedicle screw fixation with posterolateral fusion[J].Acta Neurochir (Wien),2013,155(12):2305-2312.
[11] KREINEST M,RILLIG J,GRÜTZNER P A,et al. Analysis of complications and perioperative data after open or percutaneous dorsal instrumentation following traumatic spinal fracture of the thoracic and lumbar spine:a retrospective cohort study including 491 patients[J].Eur Spine J,2017,26(5):1535-1540.
[12] DINIZ J M,BOTELHO R V. Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis[J].J Neurosurg Spine,2017,27(5):584-592.
[13] VANEK P,BRADAC O,KONOPKOVA R,et al. Treatment of thoracolumbar trauma by short-segment percutaneous transpedicular screw instrumentation:prospective comparative study with a minimum 2-year follow-up[J].J Neurosurg Spine,2014,20(2):150-156.