改良竖脊肌间隙入路椎弓根螺钉内固定术治疗胸腰椎不稳定性骨折  

Treatment of Pedicle Screw Fixation for the Unstable Thoracolumbar Fracture with Modified Intra - sacrospinal Muscular Approach

作　　者：齐勇 徐汪洋 罗狄鑫 陈为坚 金勋杰 武光勤 李贵涛 陈锡然 

机构地区：[1]广东省广州市第二人民医院骨科,510310

出　　处：《解剖与临床》2010年第6期423-425,共3页Anatomy and Clinics

摘　　要：目的：探讨经改良竖脊肌间隙入路椎弓根螺钉内固定术在治疗胸腰椎不稳定性骨折中的临床应用价值.方法：我院自2009年1月至2009年12月采用改良的后正中切开经竖脊肌间隙入路椎弓根螺钉内固定术治疗胸腰椎不稳定性骨折17例（改良组）,同期采用传统后路手术内固定术治疗胸腰椎不稳定性骨折21例（传统组）.对两组手术时间、手术出血量以及术后椎体高度恢复等方面进行对比研究.结果：改良组和传统组患者的手术时间分别为76 min和124 min,术中出血量分别为120 ml和350 ml,术后伤口引流量分别为70 ml和105 ml,两组比较差异有统计学意义（P＜0.05） 而在术后椎体高度恢复的短期治疗效果上,两组相比差异无统计学意义（P＞0.05）.结论：改良经竖脊肌间隙入路用于后路椎弓根螺钉固定技术,具有创伤小、出血少、手术时间短等优点,在治疗无需椎管减压的胸腰椎不稳定性骨折时可作为首选的手术方法.Objective：To investigate the value of postmedial intra- sacrospinal approach in the treatment of pediele screw fixation for the unstable thoracolumbar fracture. Methods： 17 cases suffered unstable fracture of thoracic or lumbar fractures from Jan to Dec of 2009 in our hospital were retrospectively analyzed, who underwent the pediele serew fixation through the intra - sacrospinal muscular approach. Meanwhile, another 21 eases who accepted pedicle screw fixation through traditional approach to spine without vertebral canal decompression were reviewed. The operation time, blood loss and the height restoration of injured vertebral in two groups were compared. Results：The operation time of the two groups was 76 mns and 124 mns , the blood loss during the operation was 128 ml and 350 ml , postoperative blood loss was 70 ml andl05 ml respectively ,the differences in lhe two groups had statistical significanee（ P 〈 0.05 ）. Conclusions：The intra- saerospinal mus- cular approach has the advantages of less bleeding and trauma, short operation time. So intranmseular approach in the treatment of pedicle screw fixation can be the best choice for the unstable thoracolumbar fractures without nerve injury.

关 键 词：胸腰椎骨折 竖脊肌 手术入路 椎弓根钉内固定 

分 类 号：R687.3[医药卫生—骨科学]