| 梁刚,李跃辉,戴传强.新型微创经皮脊柱内固定系统在无神经症状胸腰椎骨折治疗中的应用.骨科,2016,7(3): 149-154. |
| 新型微创经皮脊柱内固定系统在无神经症状胸腰椎骨折治疗中的应用 |
| Application of neotype minimally invasive percutaneous pedicle screw fixation for neurologic intact thoracolumbar fractures |
| 投稿时间：2015-11-17 |
| DOI：DOI：10.3969/j.issn.1674-8573.2016.03.002 |
| 中文关键词: 外科手术，微创性 骨折固定术，内 脊柱骨折 胸椎 腰椎 外科器械 |
| 英文关键词: Surgical procedures, minimally Fracture fixation, internal Spinal fractures Thoracic vertebrae Lumbar vertebrae Surgical instruments |
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| 中文摘要: |
| 目的 探讨新型微创经皮椎弓根螺钉（ZINA）内固定治疗无神经症状的胸腰椎骨折的有效性及优越性。方法 回顾性分析2012年9月至2015年4月我院收治的60例无神经症状、脊柱载荷评分（loading sharing classification, LSC）≤6分的胸腰椎骨折患者的临床资料，其中采用ZINA行微创经皮椎弓根螺钉内固定术的27例患者纳入微创组，行后路切开椎弓根内固定术的33例患者纳入开放组。分析评价两组患者的手术时间、术后疼痛视觉模拟量表（visual analogue scale, VAS）评分、Cobb角、椎体前缘高度压缩比及矫正丢失角度等指标。结果 随访12~25个月，平均16.9个月。两组患者的手术时间、出血量差异具有统计学意义（t=-5.519，P=0.006；t=-12.945，P=0.001）；两组患者术后即刻、术后3个月及末次随访时的VAS评分差异均有统计学意义（t=-5.375，P=0.034；t=-8.945，P=0.008；t=-10.876，P=0.003）；两组患者术后各时间点的Cobb角、椎体前缘高度压缩比均较术前明显改善（均P＜0.05），但两组间的差异均无统计学意义；术后3个月和末次随访时，两组间后凸角矫正丢失度数的差异亦无统计学意义。结论 对于无神经症状的胸腰椎骨折患者，ZINA微创经皮椎弓根螺钉内固定术因其创伤小、出血量少的优点，可作为外科手术治疗的一种选择。 |
| 英文摘要: |
| Objective To investigate the validity and superiority of percutaneous pedicle screw fixation using ZINA system for the treatment of neurologic intact thoracolumbar fractures. Methods A retrospective analysis was conducted on 60 patients with thoracolumbar fractures (no neurological symptoms, LSC≤6 points) from September 2012 to April 2015: 27 cases undergoing ZINA minimally invasive percutaneous pedicle screw fixation (minimally invasive group) and 33 patients undergoing posterior incision pedicle fixation (open surgery group). The operation time, visual analogue scale (VAS) scores, Cobb angle, the leading edge of vertebral body height, and the loss of corrective angle were compared. Results All patients were followed up for 12-25 months (mean 16.9 months). The differences in operation time and blood loss were statistically significant between two groups (t=-5.519, P=0.006; t=-12.945, P=0.001). There was significant difference in VAS scores in two groups at each time point after operation (t=-5.375, P=0.034; t=-8.945, P=0.008; t=-10.876, P=0.003). The Cobb angle and the leading edge of vertebral body height in two groups at each time point were significantly improved as compared with those preoperation (P<0.05 for all), but there was no significant difference between two groups. The difference of the loss of corrective angle between two groups also had no significant difference at 3rd month after operation and at the last follow-up. Conclusion ZINA minimally invasive percutaneous pedicle screw fixation can be used as an alternative surgical treatment for patients with thoracolumbar burst fracture without neurologic deficit for its less trauma and bleeding. |
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