CAJ | 학술논문

[目的]探讨经皮微创椎弓根螺钉固定加伤椎植骨治疗无神经损伤胸腰椎骨折的可行性及其疗效。[方法]2010年1月至2012年1月，本院收治的85例胸腰椎骨折患者，男57例，女28例；年龄22～55岁，平均48．2岁。其中T1110例，T1220例，L125例，L221例，L39例，均无脊髓神经功能损害。Denis分型为B、C型，载荷分享评分3～6分，均采用微创经皮椎弓根螺钉固定，伤椎经椎弓根椎体内异体骨植骨方法，记录手术时间，出血量，观察手术前后椎体高度、Cob’s角变化，并统计术后并发症。[结果]所有病例均获随访，平均l5（12～18）个月。手术时间平均（120±30）min ，术中出血量（200±50）mL。术后椎体高度恢复满意，矢状面畸形矫正，Cobb角矫正至（3．65±2．24）°，与术前比较均有显著性差异（ P ＜0．01）。随访中无明显的后凸角和高度丢失。3例螺帽脱落，骨折全部获得愈合，无假关节形成。[结论]经皮椎弓根螺钉内固定手术操作简便、安全可靠，具有创伤小、出血少、恢复快、住院时间短等优点。
[목적]탐토경피미창추궁근라정고정가상추식골치료무신경손상흉요추골절적가행성급기료효。[방법]2010년1월지2012년1월，본원수치적85례흉요추골절환자，남57례，녀28례；년령22～55세，평균48．2세。기중T1110례，T1220례，L125례，L221례，L39례，균무척수신경공능손해。Denis분형위B、C형，재하분향평분3～6분，균채용미창경피추궁근라정고정，상추경추궁근추체내이체골식골방법，기록수술시간，출혈량，관찰수술전후추체고도、Cob’s각변화，병통계술후병발증。[결과]소유병례균획수방，평균l5（12～18）개월。수술시간평균（120±30）min ，술중출혈량（200±50）mL。술후추체고도회복만의，시상면기형교정，Cobb각교정지（3．65±2．24）°，여술전비교균유현저성차이（ P ＜0．01）。수방중무명현적후철각화고도주실。3례라모탈락，골절전부획득유합，무가관절형성。[결론]경피추궁근라정내고정수술조작간편、안전가고，구유창상소、출혈소、회복쾌、주원시간단등우점。
[Objective] To explore the feasibility and efficacy of percutaneous pedicle screw fixation combined with bone graft for the treatment of thoracolumbar burst fractures without neurological deficit .[Methods]Totally 85 cases of thoracolumbar burst fracture without spine neurological deficit from Jan .2010 to Jan .2012 were chosen .All patients included 57 males and 28 females .Their age was 22~55 years old ,and the average age was 48 .2 years old . There were 10 cases with T11 ,25 cases with T 12 ,25 cases with L1 ,21 cases with L2 and 9 cases with L3 .Accord-ing to Denis classification ,all patients were divided into type B and type C .The load sharing score was 3~6 .All pa-tients underwent minimally invasive percutaneous pedicle screw fixation combined with bone graft .Operation time and bleeding volume were recorded .Vertebra body height and the change of Cob's angle before and after operation were observed .Postoperative complications were analyzed .[Results] All patients were followed up from 12 to 18 months (mean 15 months) .Operation time was (120 ± 30)min .Bleeding volume was (200 ± 50)ml .Vertebral body height recovered well after operation .The sagittal deformity was corrected ,and Cob's angle was corrected to 3 .65 ± 2 .24° . No obvious posterior convex angle and height loss was found during the follow up .The screw shedding was found in 3 patients .All fractures were healed .No formation of false joint happened .[Conclusion]Percutaneous pedicle screw fixation is simple ,safe and reliable ,and has advantages such as small invasion ,less bleeding ,rapid recovery and short hospitalization time .