CAJ | 학술논문

背景：胸腰椎骨折多采用传统开放复位内固定，需要广泛剥离肌肉及软组织以显露骨性标志及植骨床，出血多、创伤大。目前脊柱微创技术受到人们广泛关注。 　　目的：探讨应用经皮椎弓根螺钉内固定结合椎体成形治疗胸腰椎压缩性骨折的可行性及疗效。 　　方法：选择2007年9月至2012年5月黑龙江省大庆龙南医院骨科收治的损伤平面以下无神经功能损害，无需进行椎板减压的单纯胸腰椎骨折患者32例，分为2组，经皮微创组16例应用Sextant经皮椎弓根钉棒系统置入内固定结合椎体成形治疗，传统开放组16例采用传统切开椎弓根内固定治疗。比较两组患者的临床参数及影像学指标。 　　结果与结论：所有病例随访12-38个月，治疗后患者均恢复椎体高度并矫正椎体后凸畸形。与传统开放组比较，采用 Sextant 经皮椎弓根钉棒系统置入内固定结合椎体成形组患者创伤小，手术时间短，出血少，住院时间短，恢复快。提示经皮椎弓根钉棒系统置入内固定结合椎体成形治疗胸腰椎压缩性骨折操作简便，安全可靠，具有创伤小、出血少、疼痛轻、恢复快、住院时间短等优点。
배경：흉요추골절다채용전통개방복위내고정，수요엄범박리기육급연조직이현로골성표지급식골상，출혈다、창상대。목전척주미창기술수도인문엄범관주。 　　목적：탐토응용경피추궁근라정내고정결합추체성형치료흉요추압축성골절적가행성급료효。 　　방법：선택2007년9월지2012년5월흑룡강성대경룡남의원골과수치적손상평면이하무신경공능손해，무수진행추판감압적단순흉요추골절환자32례，분위2조，경피미창조16례응용Sextant경피추궁근정봉계통치입내고정결합추체성형치료，전통개방조16례채용전통절개추궁근내고정치료。비교량조환자적림상삼수급영상학지표。 　　결과여결론：소유병례수방12-38개월，치료후환자균회복추체고도병교정추체후철기형。여전통개방조비교，채용 Sextant 경피추궁근정봉계통치입내고정결합추체성형조환자창상소，수술시간단，출혈소，주원시간단，회복쾌。제시경피추궁근정봉계통치입내고정결합추체성형치료흉요추압축성골절조작간편，안전가고，구유창상소、출혈소、동통경、회복쾌、주원시간단등우점。
BACKGROUND:Open reduction and internal fixation has been used widely in treatment of thoracolumbar fracture. This method needs to peel off muscle and soft tissues to expose bony marker and bone graft bed, so it induces bleeding and great injury. Minimal y invasive technology has been aroused wide concern in spinal fracture. OBJECTIVE:To investigate the feasibility and efficacy of percutaneous pedicellscrew fixation (Sextant) combined with vertebroplasty in treatment of thoracolumbar compression fractures. METHODS:A total of 32 patients with thoracolumbar compression fractures were selected from Department of Orthopedics of Longnan Hospital of Daqing City of Heilongjiang Province in China between September 2007 and May 2012. Al the cases had no neurological symptoms below the injured plane. Decompression laminectomy was not required. They were equal y divided into two groups. 16 patients of the Sextant group were treated by Sextant combined with vertebroplasty, 16 patients from the traditional open group were subjected to open surgery with classical pedicle screw fixation. The clinical and radiographic data were analyzed in both groups. RESULTS AND CONCLUSION:Al cases were fol owed up for 12 to 38 months. After treatment, the height of fractured level and the kyphosis angle were restored. Compared with the traditional open group, less trauma, short operation time, less blood loss, short hospital stay and fast recovery were observed in the Sextant group. Results indicated that the technique of percutaneous pedicellscrew fixation (Sextant) combined with vertebroplasty in treatment of thoracolumbar compression fractures is simple to operate, safe, reliable, has less trauma, less blood loss, light pain, fast recovery and short hospital stay.