CAJ | 학술논문

目的：观察胸腰椎骨折患者采用 Sextant 经皮椎弓根螺钉微创系统治疗临床疗效。方法：本院2010年8月～2014年11月期间50例单个胸腰椎压缩性骨折患者，随机分为对照组(传统开放复位内固定治疗)与观察组(Sextant 经皮椎弓根螺钉微创系统治疗)各25例。比较两组平均手术时间、术中出血量、内固定后引流量、透视次数、下床活动时间及平均住院时间，两组患者内固定前、1周后矢状位 Cobb 角及椎体前缘高度百分比，比较两组患者治疗前、后疼痛评分。随访8个月统计两组患者内固定后矢状位 Cobb 角增加及椎体前缘高度百分比丢失情况，两组并发症发生情况。结果：观察组患者平均手术时间和术中平均出血量及内固定后引流量、下床活动时间、平均住院时间均明显少(短)于对照组，透视次数多于对照组，差异显著具有统计学意义，P<0.05；两组患者内固定1周后，其矢状位 Cobb 角均明显低于内固定前，椎体前缘高度百分比均明显高于内固定前，差异显著具有统计学意义，P<0.05；8个月后，观察组内固定后矢状位 Cobb 角增加(2.2±1.5)°，椎体前缘高度百分比丢失(2.4±1.3)%，与对照组的(2.3±1.4)°、(2.2±1.5)%比较，差异无统计学意义。两组患者术后VAS 评分均较术前明显改善，术后均未见明显并发症。结论：应用 Sextant 经皮椎弓根螺钉微创系统治疗胸腰椎骨折疗效显著且安全，与开放手术相比创伤小，恢复快。
목적：관찰흉요추골절환자채용 Sextant 경피추궁근라정미창계통치료림상료효。방법：본원2010년8월～2014년11월기간50례단개흉요추압축성골절환자，수궤분위대조조(전통개방복위내고정치료)여관찰조(Sextant 경피추궁근라정미창계통치료)각25례。비교량조평균수술시간、술중출혈량、내고정후인류량、투시차수、하상활동시간급평균주원시간，량조환자내고정전、1주후시상위 Cobb 각급추체전연고도백분비，비교량조환자치료전、후동통평분。수방8개월통계량조환자내고정후시상위 Cobb 각증가급추체전연고도백분비주실정황，량조병발증발생정황。결과：관찰조환자평균수술시간화술중평균출혈량급내고정후인류량、하상활동시간、평균주원시간균명현소(단)우대조조，투시차수다우대조조，차이현저구유통계학의의，P<0.05；량조환자내고정1주후，기시상위 Cobb 각균명현저우내고정전，추체전연고도백분비균명현고우내고정전，차이현저구유통계학의의，P<0.05；8개월후，관찰조내고정후시상위 Cobb 각증가(2.2±1.5)°，추체전연고도백분비주실(2.4±1.3)%，여대조조적(2.3±1.4)°、(2.2±1.5)%비교，차이무통계학의의。량조환자술후VAS 평분균교술전명현개선，술후균미견명현병발증。결론：응용 Sextant 경피추궁근라정미창계통치료흉요추골절료효현저차안전，여개방수술상비창상소，회복쾌。
Objective: To investigate the effect of percutaneous pedicle screw fixation using Sextant system in the treatment of thoracolumbar fractures. Methods: A total of 50 patients, who had undergone percutaneous pedicle screw fixation using Sextant system (25 patients) or open pedicle screw fixation (25 patients) for single-level vertebral body compression fractures from Aug. 2010 to Nov. 2014, were enrolled in this study. The operative time, blood loss, postoperative drainage amount, length of hospital stay, times of fluoroscopy, pre- and post-operative Cobb angle and anterior vertebral body height ratio were recorded , incidence of complications and compared between two groups. Results: There were significant differences in operative time, blood loss, postoperative drainage amount and length of hospital stay between two groups. Sextant system group’s times of fluoroscopy were more than the traditional open group .There was no statistical difference in pre- and post-operative Cobb angle and anterior vertebral body height ratio between two groups, while significant differences were found between pre- and post-operative Cobb angle and anterior vertebral body height ratio in each group. At 8 months after operation , Cobb angle loss was (2.2 ± 1.5) °VS (2.3±1.4)°, the anterior vertebral body height averaged with correction loss for average was (2.4±1.3)%vs (2.2±1.5)%, no significant difference was found in correction loss between two groups. Conclusion: Percutaneous pedicle screw fixation using Sextant system has a satisfactory outcome in the treatment of thoracolumbar fractures.