CAJ | 학술논문

目的比较经皮及开放单节段椎弓根螺钉固定治疗不完全胸腰椎爆裂骨折患者的安全性和有效性.方法回顾分析2009年3月至2011年1月脊柱胸腰段不完全爆裂骨折行单节段固定共44例,其中开放组20例,经皮组24例.比较两组患者手术时间、出血量、术后引流量、术前术后视觉模拟量表(VAS)评分和伤椎后凸角等.结果两组手术时间差异无统计学意义(P＞0.05)；两组术中出血量差异有统计学意义[(20±10)ml比(169±34)ml,P＜0.05]；术前及术后1年两组VAS评分差异均无统计学意义(均P ＞0.05)；术后1周VAS评分差异有统计学意义[(1.2±0.7)比(2.1±0.7),P＜0.05]；术前、术后1周及1年测量伤椎后凸角差异无统计学意义(P＞0.05).两组患者术后均未发现医源性神经损伤、内固定松动、断裂等相关并发症.结论对于A3.1或A3.2型脊柱胸腰椎骨折,经皮椎弓根螺钉单节段固定能够减少手术创伤,术后疗效安全可靠.
목적 비교경피급개방단절단추궁근라정고정치료불완전흉요추폭렬골절환자적안전성화유효성.방법 회고분석2009년3월지2011년1월척주흉요단불완전폭렬골절행단절단고정공44례,기중개방조20례,경피조24례.비교량조환자수술시간、출혈량、술후인류량、술전술후시각모의량표(VAS)평분화상추후철각등.결과 량조수술시간차이무통계학의의(P＞0.05)；량조술중출혈량차이유통계학의의[(20±10)ml비(169±34)ml,P＜0.05]；술전급술후1년량조VAS평분차이균무통계학의의(균P ＞0.05)；술후1주VAS평분차이유통계학의의[(1.2±0.7)비(2.1±0.7),P＜0.05]；술전、술후1주급1년측량상추후철각차이무통계학의의(P＞0.05).량조환자술후균미발현의원성신경손상、내고정송동、단렬등상관병발증.결론 대우A3.1혹A3.2형척주흉요추골절,경피추궁근라정단절단고정능구감소수술창상,술후료효안전가고.
Objective To compare the safety and efficacies of traditional open versus percutaneous monosegmental pedicle screw fixation in the treatment of incomplete thoracolumbar spinal fracture.Methods A retrospective analysis was conducted for 44 inpatients with a diagnosis of incomplete thoracolumbar spinal fracture ( AO classification:A3.1 and A3.2 ) undergoing monosegmental pedicle instrumentation (MSPI) from September 2008 to January 2011.There were 24 cases in percutaneous group and 20 cases in traditional open group. The mean operative duration,blood loss,blood drainage,visual analogue scale/ score (VAS) and vcrtcbral kyphotic angle at pre- and post-operation were evaluated. Results No significant differences existed in operative durations between two groups (P ＞ 0.05 ). Significant differencesbetween two groups were observed in terms of intra-operative blood loss and VAS scores at Week 1 postoperation (P ＜ 0.05 ). There were no significant differences in VAS score preoperation, 1 year postoperation or pre-and post-operative vertebral kyphotic angle ( P ＞ 0.05 ).No complications of iatrogenic neurological injury or hardware failure occurred.Conclusion The application of percutaneous monoscgmcnt pedicle instrumentation in the treatment of thoracolumbar fractures in type of A 3.1 and A 3.2 is both feasible and safe.Its postoperative therapeutic effect is comparable to that of traditional open monosegmental fixation.