CAJ | 학술논문

目的：探讨微创经皮椎弓根螺钉内固定治疗胸腰椎骨折的临床效果。方法选取2011年4月~2013年11月在本院就诊的胸腰椎骨折患者64例，随机分为微创组和开放组，每组各32例。微创组患者使用微创经皮椎弓根螺钉内固定进行治疗，开放组患者使用传统开放椎弓根螺钉内固定进行治疗。比较两者患者的手术时间、术中出血量、术后引流量、带支具离床时间、住院时间、视觉模拟评分(VAS)、Cobb角和椎体前缘高度百分比等指标。结果微创组的手术时间、术中出血量、术后引流量、带支具离床时间和住院时间与开放组比较，差异有统计学意义(P<0.05)；两组术后半年的VAS评分、Cobb角和椎体前缘高度百分比与术前比较，差异有统计学意义(P<0.05)；微创组术后半年的VAS评分、Cobb角和椎体前缘高度百分比与开放组比较，差异有统计学意义(P<0.05)。结论微创经皮椎弓根螺钉内固定对胸腰椎骨折的临床治疗效果优于传统开放椎弓根螺钉内固定，患者出血少、恢复快。
목적：탐토미창경피추궁근라정내고정치료흉요추골절적림상효과。방법선취2011년4월~2013년11월재본원취진적흉요추골절환자64례，수궤분위미창조화개방조，매조각32례。미창조환자사용미창경피추궁근라정내고정진행치료，개방조환자사용전통개방추궁근라정내고정진행치료。비교량자환자적수술시간、술중출혈량、술후인류량、대지구리상시간、주원시간、시각모의평분(VAS)、Cobb각화추체전연고도백분비등지표。결과미창조적수술시간、술중출혈량、술후인류량、대지구리상시간화주원시간여개방조비교，차이유통계학의의(P<0.05)；량조술후반년적VAS평분、Cobb각화추체전연고도백분비여술전비교，차이유통계학의의(P<0.05)；미창조술후반년적VAS평분、Cobb각화추체전연고도백분비여개방조비교，차이유통계학의의(P<0.05)。결론미창경피추궁근라정내고정대흉요추골절적림상치료효과우우전통개방추궁근라정내고정，환자출혈소、회복쾌。
Objective To explore the clinical effect of minimally invasive percutaneous pedicle screws osteosynthesis (MIPPSO) treating thoracolumbar fracture. Methods 64 patients with thoracolumbar fracture visited our hospital from April 2011 to November 2013 were selected and evenly divided into the minimally invasive group and the open group in random.In the minimally invasive group, patients were treated by MIPPSO,while in the open group,the traditional openness of pedicle screws osteosynthesis were provided.The indexes like operation time, intraoperative amount of bleeding,postoperative amount of drainage,time of being off bed with brace,hospital stay,score of visual analogue scale (VAS),Cobb angle, and percentage of anterior height in vertebral body etc. were compared in both groups. Results In the minimally invasive group,the indexes of operation time, intraoperative amount of bleeding, postoperative amount of drainage,time of being off bed with brace, and hospital stay displayed statistical difference in comparison with those in the open group (P<0.05).The VAS score,Cobb angle,and percentage of anterior height in vertebral body after half a year operation in the two groups both showed statistical differences in comparison with those before surgery (P<0.05). Be-sides,the VAS score,Cobb angle,and percentage of anterior height in vertebral body after half a year operation in the minimally invasive group displayed statistical difference after comparing those in the open group (P<0.05). Conclusion In the treatment of thoracolumbar vertebral fracture,the clinical therapeutic effect of MIPPSO is superior to that by tra-ditional openness of pedicle screws osteosynthesis at advantages of little blood loss and quick recovery.