中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
21期
1491-1493
,共3页
陈卓%赵俊强%付俊伟%杨旭敏%陈琼
陳卓%趙俊彊%付俊偉%楊旭敏%陳瓊
진탁%조준강%부준위%양욱민%진경
外科手术,最小侵入性%脊柱%内固定器
外科手術,最小侵入性%脊柱%內固定器
외과수술,최소침입성%척주%내고정기
Surgical procedures,minimally invasive%Spine%Internal fixators
目的 对比微创椎弓根钉内固定手术技术与传统切开椎弓根螺钉内固定治疗胸腰椎骨折的疗效.方法 自2005年10月至2007年10月,浙江省中医药大学附属医院浙江省金华市中医院骨科20例胸腰椎骨折患者在C型臂X线机引导下,作棘突旁微创皮肤切口骶脊肌剥离,置入GSSⅡ型椎弓根钉内固定系统并与同期收治20例行传统切开椎弓根螺钉内固定术患者就嗣手术期参数与影像学指标进行比较.结果 微创组与传统组在手术时间[(68.0±6.4 min)比(76.0±9.5)]上差异无统计学意义(P>0.05),但在切口长度[(8.1±2.0)cm比(14.2±2.5)cm]、手术出血量[(70.0±8.6)ml比(350.0±30.2)ml]、术中骶脊肌剥离长度[(5.4±0.8)cm比(16.5±2.1)cm]、术后引流量[0 ml比(110.0±20.5)ml]、术后住院时间[(5.6±1.2)d比(10.4±1.5)d]差异有统计学意义(P<0.05).两组术前术后影像学观察指标差异无统计学意义(P>0.05).随访期慢性腰痛发生率微创组明显低于传统组.结论 微创椎弓根钉技术操作简便安全,具有创伤小、出血少、疼痛轻、恢复快、住院时间短及慢性腰痛发生率低等治疗效果.
目的 對比微創椎弓根釘內固定手術技術與傳統切開椎弓根螺釘內固定治療胸腰椎骨摺的療效.方法 自2005年10月至2007年10月,浙江省中醫藥大學附屬醫院浙江省金華市中醫院骨科20例胸腰椎骨摺患者在C型臂X線機引導下,作棘突徬微創皮膚切口骶脊肌剝離,置入GSSⅡ型椎弓根釘內固定繫統併與同期收治20例行傳統切開椎弓根螺釘內固定術患者就嗣手術期參數與影像學指標進行比較.結果 微創組與傳統組在手術時間[(68.0±6.4 min)比(76.0±9.5)]上差異無統計學意義(P>0.05),但在切口長度[(8.1±2.0)cm比(14.2±2.5)cm]、手術齣血量[(70.0±8.6)ml比(350.0±30.2)ml]、術中骶脊肌剝離長度[(5.4±0.8)cm比(16.5±2.1)cm]、術後引流量[0 ml比(110.0±20.5)ml]、術後住院時間[(5.6±1.2)d比(10.4±1.5)d]差異有統計學意義(P<0.05).兩組術前術後影像學觀察指標差異無統計學意義(P>0.05).隨訪期慢性腰痛髮生率微創組明顯低于傳統組.結論 微創椎弓根釘技術操作簡便安全,具有創傷小、齣血少、疼痛輕、恢複快、住院時間短及慢性腰痛髮生率低等治療效果.
목적 대비미창추궁근정내고정수술기술여전통절개추궁근라정내고정치료흉요추골절적료효.방법 자2005년10월지2007년10월,절강성중의약대학부속의원절강성금화시중의원골과20례흉요추골절환자재C형비X선궤인도하,작극돌방미창피부절구저척기박리,치입GSSⅡ형추궁근정내고정계통병여동기수치20례행전통절개추궁근라정내고정술환자취사수술기삼수여영상학지표진행비교.결과 미창조여전통조재수술시간[(68.0±6.4 min)비(76.0±9.5)]상차이무통계학의의(P>0.05),단재절구장도[(8.1±2.0)cm비(14.2±2.5)cm]、수술출혈량[(70.0±8.6)ml비(350.0±30.2)ml]、술중저척기박리장도[(5.4±0.8)cm비(16.5±2.1)cm]、술후인류량[0 ml비(110.0±20.5)ml]、술후주원시간[(5.6±1.2)d비(10.4±1.5)d]차이유통계학의의(P<0.05).량조술전술후영상학관찰지표차이무통계학의의(P>0.05).수방기만성요통발생솔미창조명현저우전통조.결론 미창추궁근정기술조작간편안전,구유창상소、출혈소、동통경、회복쾌、주원시간단급만성요통발생솔저등치료효과.
Objective To explore the feasibility and efficacy of modified minimally invasive percutaneous pedicle screws osteosynthesis for the treatment of thoracolumbar vertebral compression fracture. Methods Twenty cases of thoracolumbar fracture without neural impairment were enrolled. None needed laminotomy decompression. With the aid of C-arm image intensifier, the GSS Ⅱ pedicle screws were inserted through four small longitudinal incisions and modified surgical instruments. Perioperative parameters and postoperative imaging indices were compared with those undergoing conventional open pedicle screws osteosynthesis in other 20 cases. Results There was no significant difference in operative time between minimal invasive group and conventional group (P > 0. 05); but the length of incisions, length of hospital stay, the volume of operative hemorrhage and post-operative drainage in minimal invasive group were significantly shorter than those in conventional group (P<0. 05) ; in each group, the comparisons of Cobb's angle, anterior vertebral height and disc height between pre and post-operation were all significantly different ( P > 0. 05 ) ; The incidence rate of chronic lower back pain in minimal invasive group was obviously lower than conventional group during the follow-up visit. Conclusion The percutaneous internal pedicle screw fixation using modified instruments has the advantages of simple manipulation, less trauma and hemorrhage, quicker recovery, less pain, shorter hospital stay and a lower incidence rate of chronic lower back pain.
