微创经皮椎弓根螺钉（Sextant-R）内固定术治疗胸腰椎骨折.docVIP

微创经皮椎弓根螺钉内固定治疗胸腰椎骨折 李长青周跃王建初同伟张正丰） 【摘要】 目的：评价微创经皮椎弓根螺钉内固定术治疗胸腰椎骨折的效果。方法：例胸腰椎骨折分为微创手术组16例手术组例，对比分析手术切口、手术时间、出血量以及后凸畸形矫正率等。结果：微创手术组手术切口（.1±1.0）vs（16.5±1.8）cm，（P0.05）, 术中出血量(81.3±21.9 vs.346.2±138.7 ml, P0.01) 及术后引流量(13.7±4.3 vs.138.6±46.5 ml, P0.01)均明显减少，手术时间明显缩短(1.2±0.6 vs.2.5±0.7 h, P 0.05)。微创手术组手术前后Cobb`s角 (3.8±2.8vs. 15.4±5.1°, P0.01)、椎体矢状面指数 (7.3±9.1vs. 19.7±10.3°, P0.01)和伤椎椎体前缘高度(86.4±6.9 vs. 63.2±14.6%, P0.01)均显著恢复。结论：在严格掌握手术适应证的前提下，微创经皮椎弓根螺钉内固定术是治疗胸腰椎骨折的较好选择。 【关键词】骨折 经皮椎弓根螺钉内固定术 Percutaneous pedicle screw fixation in thoracolumbar fracture using Sextant system LI Chang-qing,LUO Gang, ZHOU Yue, WANG Jian, CHU Tong-wei, ZHANG Zheng-feng. Department of Orthopaedics, Xin-qiao hospital, Third military medical university, Chongqing 400037, China Corresponding author: ZHOU Yue Tel: 023E-mail: happyzhou@ 【Abstract】Objective: To assess the minimally invasive surgical therapeutic result of percutaneous pedicle screw fixation in thoracolumbar fracture using Sextant system. Method: 42 thoracolumbar fracture patients were divided into two groups: 16 cases were included in the three levels Sextant percutaneous pedicle screw fixation group and 26 cases were in the open pedicle screw fixation group. Results: Compared with the open pedicle screw fixation group, patients in the Multi-level Sextant percutaneous pedicle screw fixation group experienced a significantly smaller incision size（.1±1.0 vs. 16.5±1.8 cm, P0.05）, a significant decrease in surgical blood loss(8.3±21.9 vs.346.2±138.7 ml, P0.01) and surgical draining loss (13.7±4.3 vs.138.6±46.5 ml, P0.01). Surgical time shorted significantly (1.2±0.6 vs.2.5±0.7 h, P 0.05). There were significant statistical differences in postoperative improvement of Cobb`s angle (3.8±2.8vs. 15.4±5.1°, P0.01), sagittal index (7.3±9.1vs. 19.7±10.3°, P0.01) and anterior height(86.4±6.9 vs. 63.2±14.6%, P0.01) of fracture vertebral body in the Multi-level Sextant percutaneous pedicle screw fixation group. Conclusion: Percutaneous