原著
経皮的椎弓根スクリューを用いた胸腰椎後方固定術について
—従来法との比較—
2009 年 23 巻 1 号 p. 29-35
詳細
2009 年 23 巻 1 号 p. 29-35
Background : Minimally invasive surgery has become more and more important for the treatment of traumatic spine fractures. A procedure involving percutaneous insertion of cannulated pedicle screws has recently been developed as a minimally invasive alternative to the open technique during instrumented fusion procedures.
Purpose : We report on the technique and pitfalls of percutaneous pedicle screw insertion and compare this percutaneous approach versus an open approach for dorsal instrumentation with pedicle screws to the spine.
Methods : Thirty one patients (percutaneous) and 36 patients (open) underwent bilateral pedicle screw fixation at the thoracolumbar one level. One hundred forty-four pedicle screws were bilaterally inserted into the pedicles and connected with rods using either an open dorsal standard or a percutaneous approach. Operation time, loss of blood, recovery rate of JOA, VAS (day 1), VAS (day 7), hospital stay, laboratory findings (CPK and CRP) were all evaluated to objectify possible advantages for the percutaneous operation technique.
Results : Operation time, loss of blood, VAS (day 1), VAS (day 7), hospital stay, and laboratory findings (CPK and CRP) were significantly lower in the percutaneous group.
Conclusions : Based on the results we found in the present study, percutaneous screw insertion can bring moderate advantages in acute phase although this maneuver requires scrupulous care with a small surgical field.
