两种手术方法治疗胸腰椎骨折的疗效比较  

The curative effect of two methods of surgical treatment for thoracolumbar fractures

作　　者：李树强[1,2] 杨圣[2] 芦健民[2] 赵德伟[2] 廉皓艺 付大鹏[2] 赵国权[1,2] 陈华星[2] 

机构地区：[1]遵义医学院研究生学院,贵州遵义562300 [2]大连大学附属中山医院骨科,辽宁大连116001

出　　处：《重庆医学》2014年第20期2559-2562,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(30870647)

摘　　要：目的探讨后路椎弓根schanz螺钉内固定术部分剥离伤椎椎旁肌肉与传统后路手术方法治疗胸腰椎骨折的疗效比较。方法将2010年1月至2012年1月经后路椎弓根schanz螺钉内固定术治疗胸腰椎骨折患者52例,分为两组。部分剥离伤椎椎旁肌肉组(观察组)32例,传统剥离伤椎椎旁肌肉组(对照组)20例。比较两组患者术中出血量、术后出血量、术后3dVAS评分、椎体高度矫正率、后凸Cobb角矫正率、Oswestry功能障碍指数。结果观察组患者术中出血量、术后出血量、术后3dVAS评分优于对照组。两组患者术后椎体高度矫正率、后凸Cobb角矫正率、Oswestry功能障碍指数比较,差异无统计学意义(P>0.05)。结论后路部分剥离伤椎椎旁肌肉治疗胸腰椎骨折具有创伤小、恢复快,是安全有效的手术方法。Objective To investigate the curative effects of the traditional surgical method of posterior pedicle Schanz screw fixa-tion with partially stripping injured paravertebral muscle in treating thoracolumbar fracture .Methods 52 cases with thoracolumbar fracture underwent posterior pedicle Schanz screw fixation to partially strip injured paravertebral muscle from January ,2010 to Jan-uary ,2012 .The patients were divided into partially stripping injured paravertebral muscle group （32 cases） and traditionally strip-ping injured paravertebral muscle group（20 cases） .The blood loss ,postoperative drainage ,kyphosis postoperative 3 d VAS scores , vertebral height correction rate ,Cobb angle correction ,Oswestry dysfunction indexes were copmared .Results Comparing with tra-ditionally stripping injured paravertebral muscle group ,the partially stripping injured paravertebral muscle group has better effect in transperative blood loss ,postoperative drainage and postoperative 3 d VAS scores ,the differences were statistically significant .But there was no statistical significance between the two groups in vertebral height correction rate ,kyphosis Cobb angle correction ,Os-westry dysfunction indexes .Conclusion Partially strip injured paravertebral muscle has less painful than traditional surgery does , being safe and effective with small invasion and easy to recover .

关 键 词：后路 椎旁肌 schanz螺钉 胸腰椎骨折 

分 类 号：R687.3[医药卫生—骨科学]