CAJ | 학술논문

目的：探讨微创椎弓根螺钉内固定手术与传统手术治疗胸腰椎骨折的临床效果。方法将96例患者随机分为微创组（n =44）和传统手术组（n =52）。微创组在透视下小创口经肌间隙行椎弓根螺钉内固定手术，传统手术组行传统开放式切开椎弓根螺钉内固定手术。对两组的围手术期情况、矫形影像学效果、患者疼痛程度（VAS 评分）及术后随访期间生活质量（Oswestry 功能障碍指数评分）进行评估。结果微创组术中出血量、引流量、住院时间显著少于传统手术组，差异有统计学意义（ P ﹤0.05）。术后1周、3个月、6个月的疼痛程度比较，微创组均显著低于传统手术组，差异有统计学意义（ P ﹤0.05）。微创组矫形效果与传统手术组相比差异无统计学意义（ P ﹥0.05）。Oswestry 评分显示两组患者术前均为重度功能障碍，术后均有明显改善，表现为轻度功能障碍，但微创组与传统手术组之间相比差异无统计学意义（ P ﹥0.05）。结论两种手术方式均能改善胸腰椎骨折患者的伤椎形态及生活质量，但与传统手术相比，微创手术椎弓根螺钉内固定治疗胸腰椎骨折出血量少，疼痛程度低，住院时间短，临床综合治疗效果更好。
목적：탐토미창추궁근라정내고정수술여전통수술치료흉요추골절적림상효과。방법장96례환자수궤분위미창조（n =44）화전통수술조（n =52）。미창조재투시하소창구경기간극행추궁근라정내고정수술，전통수술조행전통개방식절개추궁근라정내고정수술。대량조적위수술기정황、교형영상학효과、환자동통정도（VAS 평분）급술후수방기간생활질량（Oswestry 공능장애지수평분）진행평고。결과미창조술중출혈량、인류량、주원시간현저소우전통수술조，차이유통계학의의（ P ﹤0.05）。술후1주、3개월、6개월적동통정도비교，미창조균현저저우전통수술조，차이유통계학의의（ P ﹤0.05）。미창조교형효과여전통수술조상비차이무통계학의의（ P ﹥0.05）。Oswestry 평분현시량조환자술전균위중도공능장애，술후균유명현개선，표현위경도공능장애，단미창조여전통수술조지간상비차이무통계학의의（ P ﹥0.05）。결론량충수술방식균능개선흉요추골절환자적상추형태급생활질량，단여전통수술상비，미창수술추궁근라정내고정치료흉요추골절출혈량소，동통정도저，주원시간단，림상종합치료효과경호。
Objective To study efficacy of minimally invasive percutaneous surgery with screw internal fixation treating thoracolumbar frac-tures pedicle. Methods 96 patients with a thoracolumbar and lumbar fracture were divided into two groups randomly. Patient of minimally invasive group accepted minimally invasive percutaneous pedicle screw fixation and patient of traditional surgery group were treated with traditional open pedi-cle screw internal fixation surgery. Then the perioperative index,clinic efficacy,and imaging results were compared. Results The intraoperative blood loss,postoperative drainage,the length of stay of minimally invasive group were lower than that of traditional surgery group significantly( P ﹤0. 05). The imaging effects and Oswestry disability index were better after surgery,but there was no significant difference between minimally invasive group and traditional surgery group( P ﹥0. 05). Conclusion Minimally invasive operation in the treatment of thoracolumbar fractures has small in-cision,less blood loss,quick recovery,less postoperative pain. The comprehensive curative effect is superior to the traditional open surgery.