开放手术与微创手术治疗胸腰椎骨折的疗效比较

田浩南

（陕西省商洛市洛南县医院，陕西 商洛，726100）

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摘要：

目的 探讨开放手术与微创手术治疗胸腰椎骨折的临床疗效。方法 回顾性分析2011年5月至2015年12月我院诊治 的胸腰椎骨折患者106 例的临床资料，将106例患者根据手术方式的不同分为观察组（48例）和对照组（58例）。观察组行经皮椎弓根螺钉内固定微创手术治疗，对照组行传统开放椎弓根螺钉内固定手术治疗，比较两组患者的围手术期指标、影像学 指标及术后并发症发生情况。结果 观察组的手术时间、术中出血量、术后引流量、住院天数及术后6个月VAS评分均显著优 于对照组（P<0.05）。两组术前伤椎前缘相对高度、伤椎间隙高度、后凸Cobb 角、椎管堵塞指数比较，差异无统计学意义（P> 0.05）；术后1周，两组影像学指标水平均较术前显著改善（P<0.05），但术后两组间各指标比较，差异不显著（P>0.05）。观察组 术后并发症总发生率为2.08%，明显低于对照组的17.24%（P<0.05）。结论 与传统开放手术相比，经皮椎弓根螺钉内固定微创手术治疗胸腰椎骨折手术时间短，创伤小，术后恢复快，住院时间短，术后疼痛轻，且临床疗效与传统手术相当，而安全性 更高，值得临床推广应用。

关键词：胸腰椎骨折；开放手术；微创手术

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2017)29-0079-02

Curative effects comparison of open surgery and minimally invasive surgery on thoracolumbar fractures
TIAN Hao-nan
(Luonan County Hospital, Shangluo 726100, China)

ABSTRACT: Objective To investigate the clinical efficacy of open surgery and minimally invasive surgery on thoracolumbar fractures. Methods The clinical data of 106 patients with thoracolumbar fractures in our hospital from May 2011 to December 2015 were retrospectively analyzed. All the patients were divided into observation group (48 cases) and control group (58 cases) according to different operation methods. The observation group received percutaneous pedicle screw fixation with minimally invasive surgery, while the control group was treated with traditional open pedicle screw fixation. The perioperative indicators, imaging indexes and postoperative complications were compared between the two groups. Results The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization time and VAS score of 6 months after operation in the observation group were significantly better than those in the control group (P<0.05). Before surgery, there were no significant differences between the two groups in the relative height of vertebral anterior border, gap height of injured vertebra, kyphosis Cobb and blockage index (P>0.05); 1 week after operation, the above indexes in the two groups significantly improved (P<0.05), but there were no significant differences in those indexes between the two groups after operation (P>0.05). The total incidence rate of postoperative complications in the observation group was 2.08%, which was significantly lower than 17.24% in the control group (P<0.05). Conclusion Compared with traditional open surgery, percutaneous pedicle screw fixation with minimally invasive surgery in the treatment of thoracolumbar fractures has shorter operation time, less trauma, faster postoperative recovery, shorter hospitalization time, less postoperative pain. The clinical curative effect is equivalent to the traditional operation and more safety, so it is worthy of clinical application.
KEYWORDS: thoracolumbar fractures; open surgery; minimally invasive surgery

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