Quadrant通道下微创手术治疗胸腰椎骨折的临床分析  

Clinical analysis on minimally invasive operations for thoracolumbar fracture of 58 cases through Quadrant passage

作　　者：徐烁 党小伍 肖建春 陈子华 

机构地区：[1]河源市人民医院骨科,广东河源517000

出　　处：《中国临床解剖学杂志》2014年第4期471-475,共5页Chinese Journal of Clinical Anatomy

基　　金：广东省医学科研基金立项资助项目(A2012778)

摘　　要：目的探讨Quadrant通道下微创手术治疗胸腰椎骨折的适应症及方法。方法从2010年4月至2012年10月我们收治的胸腰椎骨折中选择58例合适病例，采用后正中小切口，Quadrant通道下经肌间隙微创手术、椎弓根钉棒系统内固定治疗胸腰椎骨折，部分病例进行了微创减压，临床疗效采用临床和影像学指标综合评价。结果所有病例均顺利完成手术，术后随访18～36个月，平均25．2个月。综合评价结果显示相对于传统手术，微创手术具有创伤小、出血量少、手术时间短、腰背痛轻等优点，而在骨折复位、减压、内固定效果、植骨融合、运动功能恢复方面与传统手术相似甚至更好。结论采用Quadrant通道下微创手术治疗胸腰椎骨折效果良好，并适当扩大了微创手术治疗胸腰椎骨折的适应症。Objective To explore the indications and methods of minimally invasive operation for thoracolumbar fracture through Quadrant passage. Methods From April 2010 to October 2012,58 selected patients with thoracolumbar fracture received internal fixation with pedicle screw-rod system through Quadrant passage in our department. They were treated with minimally invasive operation through posterior midline surgical approach between multifidus muscle and longissimus. Decompressions were performed on the some cases. The curative effect was assessed by clinical and radiographical indexes. Results All patients underwent successful operations and the following-up ranged from 18 to 36 months. Compared with the conventional surgical approaches, the minimally invasive surgical approach have the advantages of minimal invasion, less blood loss, shorter operation time and less back pain, and they also have similar or even better outcome on reduction, decompression, internal fixation, fusion and motor function recovery of the thoracolumbar fracture. Conclusion Minimally invasive operations via Quadrant passage have good effect on thoracolumbar fracture and the indications of minimally invasive operation can be properly broadened by using Quadrant passage.

关 键 词：胸腰椎 骨折 微创 手术 

分 类 号：R683.2[医药卫生—骨科学]