椎旁肌间隙入路经椎弓根内固定治疗胸腰椎骨折  

Treatment of Pedicle Screw Fixtion for the Thoracolumbar Fracture with Intrasacrospinal Muscular Approach

作　　者：李俊[1] 王江南[1] 沙玉山 王雪峰[1] 刘辉[1] 邵松[2] 

机构地区：[1]安徽省六安市第二人民医院骨科,安徽六安237000 [2]安徽省六安市人民医院骨科,安徽六安237005

出　　处：《实用骨科杂志》2011年第9期777-779,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨胸腰椎后路经椎旁肌间隙入路椎弓根螺钉内固定治疗胸腰椎骨折中的临床应用价值。方法自2009年1月至2010年12月采用椎旁肌间隙入路椎弓根螺钉内固定治疗胸腰椎骨折31例,全部病例均采用两侧钝性分离最长肌和多裂肌间隙显露关节突,置入椎弓根螺钉并复位内固定。结果本组平均手术时间100 min,平均术中出血量140 mL,平均术后引流量60 mL,无血肿及术后感染。19例经6～12个月随访,无腰背痛,效果优良。结论椎旁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、术后恢复快等优点,在治疗无需椎管减压的胸腰椎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 pedicle screw fixation for the thoracolumbar fracture.Methods 31 cases suffered fracture of thoracic or lumbar fractures from Jan 2009 to Dec 2010 were retrospectively analyzed,who underwent the pedicle screw fixtion through intra-sacrospinal muscular approach without vertebral canal decompression.All cases who were operated with vertebral posterior nearby intermuscule between spinous muscle and longissimus muscle approach.Results The operation time was 90～150 min,and mean duration was 100 min.Blood loss in operation was 100～200 mL,mean loss was 140 mL and in postoperatively was 10～100 mL,mean loss 60 mL.19 patients were followed up.The period of follow-up was 6～12 months,the mean was 10 months,All patients did not complain of pain in operative region.The outcomes of operation was satisfactory.Conclusion The intra-sacrospinal muscular approach has the advantages of less bleeding, minimize tissue trauma.shorten operative and recovery time.So intramuscular approach in the treatment of pedicle screw fixation can be the best choice for the thoracolumbar fractures without nerve injury.

关 键 词：胸腰椎骨折 椎旁肌间隙入路 椎弓根内固定 

分 类 号：R683.2[医药卫生—骨科学]