椎旁肌间隙入路结合术前手法复位治疗胸腰椎骨折  

Pedicle screw system through paraspinal approach combined preoperative manual and postural reduction for thoracolumbar fractures

作　　者：王延国[1] 鲁秀国[1] 周忠水[1] 翟贵亮[1] 郑燕平[2] 

机构地区：[1]滨州市中心医院骨脊柱外科,山东251700 [2]山东大学齐鲁医院

出　　处：《脊柱外科杂志》2013年第3期137-140,共4页Journal of Spinal Surgery

摘　　要：目的对比观察应用后路经椎旁肌间隙入路椎弓根螺钉内固定结合手法复位治疗胸腰椎骨折的疗效。方法 2005年6月～2011年12月共收治单纯性压缩性胸腰椎骨折患者70例。随机采用椎旁肌间隙入路手术36例,传统骶棘肌剥离入路手术34例。比较2种术式的手术时间、术中出血量、术后引流量、后凸Cobb角矫正率、椎体塌陷矫正率、疼痛视觉模拟量表(visual analogue scale,VAS)评分等。结果 2组手术在手术时间、术中出血量、术后引流量方面差异有统计学意义(P<0.05),拆除内固定后椎旁肌间隙入路VAS评分高。结论椎旁肌间隙入路椎弓根螺钉内固定结合术前手法复位治疗胸腰椎骨折具有操作简便、安全,术中创伤小,出血少,术后恢复快等优点。Objective To compare the clinical results between paraspinal approach combined preoperative manual and postural reduction and conventional posterior midline approach for thoracolumbar fracture. Methods From June 2005 to December 2011,70 patients with thoracolumbar vertebral compression or burst fractures without neural syndromes underwent reposition and internal fixation by the screw-rod system. The patients were divided into 2 groups randomly： Group A through paraspinal approach, and Group B conventional posterior midline approach. The data between 2 groups were compared, such as operation time,blood loss and visual analog scale （VAS） scores. Results All patients were followed up for 18 months. The differences of postoperative correction rate of Cobb＇ s angle and accuracy of pedicle screw placement between 2 groups were not statistically significant （ P 〉 0.05 ） . The operation time, blood loss and postoperative volume of drainage of Group A were less than those of the Group B （ P 〈 0.05 ）. The postoperative VAS score of Group A were lower than those of the Group B （ P 〈0. 05）. Conclusion Pedicle screw system through paraspinal approach combined preoperative manual and postural reduction is a better way than the posterior midline approach for thoracolumbar fractures that has no need of decompression, less trauma, less injury of paraspinal muscle and more relief of postoperative low back pron.

关 键 词：胸椎 腰椎 脊柱骨折 手法 骨科 内固定器 

分 类 号：R683.2[医药卫生—骨科学]