Wiltse肌间隙入路与传统后正中入路在治疗胸腰段骨折的比较研究  

A comparative study of Wiltse paraspinal inlet surgery and conventional posterior median inlet surgery in treatment of thoracolumbar vertetral fractures

作　　者：那孟奇[1] 

机构地区：[1]广西柳州市工人医院广西医科大学第四附属医院骨科,广西柳州545005

出　　处：《右江民族医学院学报》2011年第2期145-147,共3页Journal of Youjiang Medical University for Nationalities

摘　　要：目的比较研究经Wiltse肌间隙入路治疗胸腰椎骨折手术技术与传统后正中入路治疗胸腰椎骨折的临床效果。方法采用后路钉棒系统撑开复位内固定技术治疗胸腰段椎体骨折患者61例,ASIA分级均为E级。随机采用Wiltse肌间隙入路31例,男20例,女11例,年龄23-54岁,平均41.8岁;传统后正中入路30例,男21例,女9例,年龄20-55岁,平均43.6岁。比较围手术期参数,术前1天及术后1、6个月进行视觉模拟数字法（VAS）疼痛评分。结果 Wiltse肌间隙入路组与传统后正中入路组手术时间差异无显著性（P〉0.05）;Wiltse肌间隙入路组术中出血量及住院时间明显低于传统后正中入路组（P〈0.01）。Wiltse肌间隙入路组与传统后正中入路组术前1天VAS评分差异无显著性（P〉0.05）,而术后1、6个月VAS评分均明显低于传统入路组。结论与传统后正中入路比较,Wiltse肌间隙入路具有术中创伤小、术后恢复好、住院时间短等优点。Objective To compare the clinical outcomes between Wiltse paraspinal inlet surgeryand conventional posterior median inlet surgery for thoracolumbar vertebral fractures.Methods A total of 61 patients with thoracolumbar vertebml fracture（ASIA E） undergoing posterior open reduction and internal fixation with pedicle screw fixation system were randomly allocated to two groups. The Wiltse group（n=31） patients received Wiltse paraspinal inlet surgery,including 20 males and 11 females,aged from 23 to 54 years with the mean age of 41.8 years;the conventional group（n=30） patients received conventional posterior median inlet surgery,including 21 males and 9 females aged from 20 to 55 years with the mean age of 43.6 years.A comparison of the perioperative indexes,of the records of one day before operation and one-and six-months visual analoque pain scale（VAS） were done.Results Compared to conventional posterior median inlet surgery group,there was no significant difference of surgical time（P〉0.05）,but less blood loss,shorter hospitalized time（P〈0.01） in Wiltse paraspinal inlet surgery group.Compared of the VAS scores one day before operation in Wiltse paraspinal surgery group to conventional posterior median inlet surgery group,there was not statistically difference（P〉0.05）,but one-and six-months of VAS scores were lower in Wiltse paraspinal surgery group than those in conventional posterior median inlet surgery group.Conclusion The Wiltse paraspinal inlet surgery for treatment of thoracolumbar spinal fracture has the advantages of less injuries,better recovery and shorter hospitalization time.

关 键 词：骨折固定术 内 胸椎 腰椎 脊柱骨折 

分 类 号：R683[医药卫生—骨科学]