本文選題：胸腰椎骨折 + 微創(chuàng)�。� 參考：《遵義醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的:探討開(kāi)放經(jīng)單側(cè)椎管植骨內(nèi)固定手術(shù)與微創(chuàng)經(jīng)椎弓根植骨內(nèi)固定手術(shù)治療胸腰椎骨折的近期療效比較,為臨床應(yīng)用提供科學(xué)依據(jù)。方法:選取2013年3月~2014年5月期間遵義醫(yī)學(xué)院附屬醫(yī)院脊柱外科收治39例胸腰椎骨折的臨床資料,并選用兩種不同的手術(shù)方法進(jìn)行療效比較:1.開(kāi)放經(jīng)單側(cè)椎管植骨內(nèi)固定手術(shù);2.微創(chuàng)經(jīng)椎弓根植骨內(nèi)固定手術(shù);微創(chuàng)組16例,開(kāi)放組23例,術(shù)后隨訪8~15月,通過(guò)對(duì)兩手術(shù)患者之間圍手術(shù)期相關(guān)指標(biāo)、近期隨訪的影像學(xué)指標(biāo)、術(shù)后腰背部疼痛癥狀改善的情況進(jìn)行比較并做出統(tǒng)計(jì)學(xué)分析。結(jié)果:1、圍手術(shù)期參數(shù)微創(chuàng)組在手術(shù)時(shí)間、術(shù)中出血量、術(shù)區(qū)引流量及住院天數(shù)具有優(yōu)勢(shì),但“X”線暴露時(shí)間較長(zhǎng),微創(chuàng)組和開(kāi)放組比較具有統(tǒng)計(jì)學(xué)差異(P0.05)。2、影像學(xué)結(jié)果微創(chuàng)組和開(kāi)放組術(shù)后的傷椎椎體前緣高度、Cobb角度數(shù)、矢狀面指數(shù)較術(shù)前有改善,改善差異具有統(tǒng)計(jì)學(xué)意義(P0.05),但微創(chuàng)組術(shù)后傷椎前緣高度、Cobb角度數(shù)及矢狀面指數(shù)的改善程度與開(kāi)放組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P≥0.05),隨訪期間微創(chuàng)組和開(kāi)放組的矯正度丟失差異無(wú)統(tǒng)計(jì)學(xué)意義(P≥0.05)。3、疼痛恢復(fù)情況評(píng)估微創(chuàng)組和開(kāi)放組疼痛程度在術(shù)后3天均有減輕,兩組減輕的程度與術(shù)前比較有改善,改善存在差異,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。微創(chuàng)組術(shù)后3月內(nèi)疼痛程度改善更加明顯,與開(kāi)放組比較存在統(tǒng)計(jì)學(xué)意義(P0.05),但微創(chuàng)組及開(kāi)放組術(shù)后12月及末次隨訪疼痛程度基本相同,比較無(wú)統(tǒng)計(jì)學(xué)差異(P≥0.05)。結(jié)論：1.在掌握手術(shù)適應(yīng)癥前提下治療胸腰椎骨折,微創(chuàng)和開(kāi)放兩種手術(shù)方式治療效果相當(dāng)。2.雖然微創(chuàng)手術(shù)過(guò)程“X”透視時(shí)間較多,但在手術(shù)時(shí)間、術(shù)中出血量、術(shù)區(qū)引流量、住院時(shí)間及術(shù)后恢復(fù)并發(fā)癥等方面的療效優(yōu)于開(kāi)放手術(shù)。
[Abstract]:Objective: to compare the short-term curative effect of open unilateral vertebral canal graft internal fixation and minimally invasive transpedicular bone graft internal fixation in the treatment of thoracolumbar fractures, and to provide scientific basis for clinical application.Methods: from March 2013 to May 2014, 39 cases of thoracolumbar fractures were treated in the Department of Spine surgery, affiliated Hospital of Zunyi Medical College.Open bone graft internal fixation through unilateral spinal canal 2.Minimally invasive transpedicular bone graft internal fixation, minimally invasive group (16 cases) and open group (23 cases) were followed up for 8 ~ 15 months.The improvement of lumbar and back pain after operation was compared and statistically analyzed.Results: the microinvasive group had advantages in operation time, intraoperative bleeding volume, drainage volume and hospitalization days, but the exposure time of "X" ray was longer than that of the control group.There was significant difference between the minimally invasive group and the open group (P 0.05). The results of the imaging results showed that the anterior height of the injured vertebrae in the minimally invasive group and the open group were improved by Cobb angle and sagittal index.The difference was statistically significant (P > 0.05), but there was no significant difference in the degree of improvement of Cobb angle and sagittal index between the minimally invasive group and the open group (P 鈮，

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