摘要
目的比较经皮与Wiltse入路椎弓根螺钉治疗单节段胸腰椎骨折的疗效。方法对44例无神经损伤的胸腰椎骨折患者分别采用经皮椎弓根螺钉固定治疗(经皮组,23例)和Wiltse入路椎弓根螺钉固定治疗(Wiltse组,21例)。比较两组手术时间、术中出血量、切口长度、透视次数、术后腰痛VAS评分,比较两组术后6个月椎体高度恢复率、Cobb角改善率、ODI。结果 43例获得随访,时间6～18个月;1例失访。与Wiltse组相比,经皮组手术时间长、透视次数多、出血少、腰痛程度轻,差异均有统计学意义(P<0.05)。手术切口长度、椎体高度恢复率、Cobb角改善率、ODI两组比较差异无统计学意义(P>0.05)。结论经皮与Wiltse入路椎弓根螺钉内固定治疗胸腰椎骨折均是微创方式,临床效果基本相同。经皮入路具有出血少、腰痛轻等优点,Wiltse入路具有可视化、易操作等优点。
Objective To compare the efficacy of percutaneous and Wiltse muscle approach pedicle screw fixation for treatment of single segment thoracolumbar fractures. Methods The 44 patients without neurological damage were treated with percutaneous pedicle screw fixation（ percutaneous group,23 cases） and Wiltse muscle approach pedicle screw fixation（ Wiltse group,21 cases）. The operative time,intraoperative bleeding,incision length,fluoroscopy times and postoperative lumbar pain VAS were compared between two groups. Vertebral height recovery rate,Cobb angle improvement rate and ODI at 6 months after operation were compared. Results The 43 cases were followed up for 6 ~ 18 months,and 1 case was lost. Compared with Wiltse group,percutaneous group had longer operative time,more fluoroscopy times,less bleeding,lower lumbar pain,the differences were significant（ P 0. 05）. There were no significant differences in the length of incision,vertebral height recovery rate,Cobb angle improvement rate and ODI（ P 0. 05）. Conclusions Percutaneous pedicle screw fixation and Wiltse muscle approach pedicle screw fixation for treatment of thoracolumbar fractures are minimally invasive,the clinical effect is basically the same. The percutaneous pedicle screw fixation has many advantages,such as less blood loss,lower back pain,Wiltse approach has the advantages of visualization,easily operating and so on.
作者
夏太宝
赵广超
薛双桃
张小海
朱玉婷
XIA Tai-bao, ZHAO Guang-chao, XUE Shuang-tao, ZHANG Xiao-hai, ZHU Yu-ting(Section Ⅲ, Dept of Orthopaedics, the Second People＇s Hospital of Wuhu, Wuhu ,Anhui 241000, China)
出处
《临床骨科杂志》
2018年第4期415-418,共4页
Journal of Clinical Orthopaedics
