微创椎弓根螺钉治疗不稳定性胸腰椎骨折的疗效分析

doi:10.3969/j.issn.1671-7171.2017.02.013

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Abstract 【Objective】To investigate the clinical efficacy of the minimally invasive pedicle screw fixation for the treatment of unstable thoracolumbar fractures. 【Methods】Thirty-seven patients of unstable thoracolumbar fracture without neurological symptoms from January 2011 to October 2012 were seen in the Departments of Orthopedics of the First and Second Hospitals of Xi'an Jiaotong University. There were 24 males and 13 females, aged 19 to 69 years (mean 31.8 ± 8.5 years). All cases were treated with minimally invasive percutaneous pedicle screw fixation techniques. The operation time, blood loss, vertebral height before and after surgery, Cobb's angle changes, and postoperative complications were collected and statistical analysis was conducted. 【Results】The operation time was 1.1 (0.75 ~ 1.5) h, the bleeding volume was 20~100 (40.5±10) mL, and the follow-up time was 10~36 (19.8±5.6) months. There were significant differences in VAS scores four weeks and one year after operation compared to that on one day before operation (P<0.05), showing a significant reduction in pain. The percentage of vertebral body height and Cobb's angle were significantly higher than those before treatment, and the difference was statistically significant (P<0.05). The percentage of vertebral height and Cobb's angle before treatment and after treatment were significantly different (P<0.05). However, there were no statistical difference between these values one month and twelve months after surgery (P>0.05). Intraoperative complications accounted for three cases (8.1%), caused by improper pedicle screw placement resulting in piercing the outer wall, while there were no rupture of the dura mater and vascular injury patients. However, follow-up showed fracture healed without much deformity and height loss. The twelve-month follow-up had two patients with a total of three loose pedicle screws. There were two cases (5.4%) of ruptured pedicle screw; one case was seen six months after operation and another case was seen twelve months after operation. Only one case (2.7%) showed pedicle screw withdrawal twenty-four months after operation.【Conclusion】Minimally invasive percutaneous pedicle screw technology can minimize the damage on stability of the disease, not only to achieve the purpose of stabilizing the spine, but also to reduce intraoperative trauma. Under the premise of strict control of surgical indications, it can be widely used as a basic technology.

Key words： Surgical Procedures, Minimally Invasive Fracture Fixation, Internal/IS Spinal Fractures Thoracic Vertebrae/IN Lumbar Vertebrae/IN Follow-Up Studies

Received: 07 July 2016

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R683.2

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http://www.jcr.net.cn/EN/10.3969/j.issn.1671-7171.2017.02.013 OR http://www.jcr.net.cn/EN/Y2017/V34/I2/247

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