CAJ | 학술논문

目的：比较Sextant系统经皮椎弓根螺钉内固定与内窥镜辅助下椎弓根螺钉内固定治疗胸腰椎骨折的临床效果。方法将2003年2月至2012年2月确诊为无神经功能损伤的80例单节段胸腰椎骨折患者随机分为A组与B组，每组40例。A组采用Sextant系统经皮椎弓根螺钉内固定治疗，B组采用内窥镜辅助下椎弓根螺钉内固定治疗。比较两组在围手术期中各项指标、影像学观察结果以及VAS评分。结果 A组手术时间显著短于B组，术中出血量也显著少于B组，均具统计学差异（P<0.05），组间住院时间与手术切口长度无统计学差异（P>0.05）；A组术后Copp角显著小于B组，术后椎前缘高度矫正程度优于B组，但丢失量显著大于B组（P<0.05），A、B两组术后矢状面指数基本相近；A组术后VAS分数明显低于B组（P<0.05）。结论 Sextant系统经皮椎弓根螺钉内固定术与内窥镜辅助下椎弓根螺钉内固定术均具有其各自的优缺点，但Sextant系统经皮椎弓根螺钉内固定相对而言，操作简单，可减少术中出血量与手术时间，更好地维持伤椎前缘高度。
목적：비교Sextant계통경피추궁근라정내고정여내규경보조하추궁근라정내고정치료흉요추골절적림상효과。방법장2003년2월지2012년2월학진위무신경공능손상적80례단절단흉요추골절환자수궤분위A조여B조，매조40례。A조채용Sextant계통경피추궁근라정내고정치료，B조채용내규경보조하추궁근라정내고정치료。비교량조재위수술기중각항지표、영상학관찰결과이급VAS평분。결과 A조수술시간현저단우B조，술중출혈량야현저소우B조，균구통계학차이（P<0.05），조간주원시간여수술절구장도무통계학차이（P>0.05）；A조술후Copp각현저소우B조，술후추전연고도교정정도우우B조，단주실량현저대우B조（P<0.05），A、B량조술후시상면지수기본상근；A조술후VAS분수명현저우B조（P<0.05）。결론 Sextant계통경피추궁근라정내고정술여내규경보조하추궁근라정내고정술균구유기각자적우결점，단Sextant계통경피추궁근라정내고정상대이언，조작간단，가감소술중출혈량여수술시간，경호지유지상추전연고도。
Objective To observe and compare clinical effect of Sextant percutaneous pedicle screws fixation and minimally invasive internal fix-ation by endoscope. Methods 80 cases of thoracolumbar fracture with no neurological damage from February 2003 to February 2012 in our hospital was randomly divided into group A(40 cases) and group B(40 cases). The patients in group A were treated with Sextant percutaneous pedicle screws fixation, and in group B were treated with minimally invasive internal fixation by endoscope. The related perioperative indicators, radiographic observation and VAS score were compared. Results The operation time of group A was significantly shorter than that of group B, blood loss of group A was significantly less than that of group B, and there were significant differences (P<0.05). The hospital time and surgical incision length between the two groups had no statistically differ-ence (P>0.05). The postoperative Copp angle of group A was significantly less than group B. The correction degree of the fracture vertebral body of group A was better than group B, but the loss of anterior height of the fracture vertebral body of group A was significantly greater than that of group B (P<0.05). The postoperative sagittal index in 2 groups was basically similar. The postoperative VAS of group A was less than group B (P<0.05). Conclusion Sextant percutaneous pedicle screws fixation and minimally invasive internal fixation by endoscope had its own advantages and disadvantages. Comparing with mini-mally invasive internal fixation by endoscope, the operation of Sextant percutaneous pedicle screws fixation was more simple, less blood loss, less operative time, and could better maintain the anterior height of the fracture vertebral body.