崔基浩+何二兴+金东叁

【摘要】 目的：观察经皮椎弓根置钉微创治疗无神经损伤胸腰椎骨折的临床疗效。方法：随机选取2013年1月-2016年12月于本院就诊的无神经损伤胸腰椎骨折患者74例，按照治疗方法的不同分为观察组与对照组，每组各37例。观察组患者给予经皮椎弓根置钉微创治疗，对照组患者给予常规开放手术治疗，对比两组患者的治疗结果。结果：观察组患者的切口长度术、中出血量、手术时间、下地时间、住院时间均优于对照组（P<0.05）；两组患者术前VAS评分对比差异无统计学意义（P>0.05），观察组患者术后3 d、7 d、1年VAS评分均显著低于对照组，两组比较差异有统计学意义（P<0.05）；两组患者术前、术后3 d、7 d、1年伤椎前缘高度比、Cobb角对比差异无统计学意义（P>0.05）。结论：经皮椎弓根置钉微创治疗无神经损伤胸腰椎骨折的的手术效果良好，具有推广使用价值。

【关键词】 椎弓根置钉； 微创； 胸腰椎骨折

【Abstract】 Objective：To observe the clinical effect of percutaneous pedicle screw fixation for thoracolumbar fractures without nerve injury.Method：From January 2013 to December 2016，74 patients with thoracolumbar fractures without nerve injury in our hospital were randomly selected，according to the different treatment methods they were divided into observation group and control group，37 cases in each group.The observation group was treated by percutaneous pedicle screw minimally invasive treatment，the control group was given routine open surgery，the treatment results were compared between the two groups.Result：The incision length，intraoperative bleeding operation time，ambulation time and hospitalization time of observation group were all better than those of the control group（P<0.05）.Preoperation VAS scores of two groups were no significant differences（P>0.05），after operation 3 days 7 days and 1 years，the VAS scores of observation group were significantly lower than those of the control group（P<0.05）.Before opration and after operation 3 days，7 days and 1 years，the anterior vertebral height rate and Cobb angle of two groups were no significant differences（P>0.05）. Conclusion：Minimally invasive percutaneous pedicle screw fixation for the treatment of thoracolumbar fractures without nerve injury has a good results and is worth of being generalized.

【Key words】 Pedicle screw fixation； Minimally invasive； Thoracolumbar fractures

First-authors address：The Fourth Affiliated Hospital of Guangzhou University，Guangzhou 511447，China

doi：10.3969/j.issn.1674-4985.2017.13.033

胸腰椎骨折是常見的脊柱损伤，是由外力导致的胸腰椎骨质连续性破坏，患者在受伤后局部会出现剧烈的疼痛，并伴随着损伤部位的压痛[1]。常规开放手术是临床上常用的治疗方式，固定效果较好，但手术切口大、术中出血多，存在患者术后腰背痛、恢复慢等缺点[2-3]。本文采用经皮椎弓根置钉微创治疗，并与常规开放手术治疗效果对比，现报告如下。

1 资料与方法

1.1 一般资料 随机选取2015年1月-2016年12月于本院就诊的无神经损伤腰椎骨折患者74例，所有患者均经过影像学检查且符合诊断标准，排除神经损伤、陈旧性骨折、代谢性骨病、骨质疏松患者。本研究均征得本院医学伦理委员会批准，患者知情同意并签署知情同意书。……