Wiltse经椎旁肌间隙入路治疗胸腰椎骨折的疗效分析  

Analysis of effect Wiltse paraspinal approach to thoracolumbar fractures

作　　者：潘峰[1] 陶海鹰[1] 任岳[1] 李章华[1] 郭卫春[1] 陶凤华[1] 贺斌[1] 

机构地区：[1]武汉大学人民医院脊柱外科/骨一科,430060

出　　处：《临床外科杂志》2013年第5期378-380,共3页Journal of Clinical Surgery

摘　　要：目的 探讨Wiltse经椎旁肌间隙入路治疗胸腰椎骨折的手术效果,并与传统后正中入路进行比较.方法 应用后路椎弓根钉棒系统治疗无神经损伤表现的单节段胸腰椎骨折51例,其中23例采用Wiltse经椎旁肌间隙入路,28例采用传统后正中入路.观察两组病例在手术时间、术中出血量、术后引流量、手术前后疼痛视觉模拟评分（VAS）等方面的差异.结果 Wiltse经椎旁肌间隙入路组的手术时间、术中出血量及术后引流量均显著少于传统后正中入路组（P〈0.05）;VAS评分在术前1d时两组间差异无统计学意义（P〉0.05）,术后1、8周时前者明显低于后者（P〈0.05）.结论与传统后正中入路相比,采用Wiltse经椎旁肌间隙入路治疗胸腰椎骨折可缩短手术时间,减轻椎旁肌损伤,减少术后腰背痛的发生.Objective To compare the clinical outcomes between the Wiltse paraspinal approach and the conventional posterior midline approach in the treatment of thoracolumbar fractures. Methods A total of 51 cases subjected to unisegmental thoracolumbar fracture without neurological symptoms underwent posterior open reduction and internal fixation surgery with pedicle screw-rod system. All cases were divided into two groups ：the group receiving the Wiltse paraspinal approach（ n = 23）and the group receiving the conventional posterior mid- line approach（ n = 28）. The operative duration ,intraoperative blood loss ,postoperative drainage ,and pain visual analogue scale（VAS）were compared between two groups. Results The operative duration,intraoperative blood loss and postoperative drainage of the Wihse group was significantly less than the conventional group. The VAS in the former group was significantly lower than that in the latter group at the 1st and 8th week postoperatively, although there was no significant difference between two groups on the 1st day preoperatively. Conclusion Compared with the conventional posterior midline approach,the Wihse paraspinal approach could decrease operative duration,relieve paraspinal muscle injury, and thus reduce postoperative lower back pain in the treatment of thoracolumbar fractures.

关 键 词：脊柱骨折 胸椎 腰椎 外科手术 对比研究 

分 类 号：R683.1[医药卫生—骨科学]