两种入路治疗胸腰段椎体压缩性骨折的疗效分析  

Analysis of curative effects by two approaches in the treatment of thoracolumbar compression fracture of vertebral body

作　　者：黎昭华[1] 汤勇智[1] 杨立群[1] 王贵清[1] 利洪艺[1] 卿勇军[1] 

机构地区：[1]广东省清远市人民医院,511518

出　　处：《中国实用医药》2015年第18期1-3,共3页China Practical Medicine

基　　金：经肌间隙入路短节段固定治疗胸腰段椎体压缩性骨折(项目编号:00161171320721011)

摘　　要：目的观察椎旁肌间隙入路治疗胸腰段椎体压缩性骨折的疗效。方法 42例无需椎管减压的胸腰椎压缩性骨折患者,采用椎旁肌间隙入路21例(A组),传统后正中入路21例(B组),并均行后路短节段内固定术,分析比较两组的术中情况和术后效果。结果 A组手术时间、切口长度、术中出血量均显著优于B组,差异具有统计学意义(P<0.05);A、B组Cobb角纠正率相近,差异无统计学意义(P>0.05);B组术后多裂肌较术前显著萎缩,差异具有统计学意义(P<0.05);术后1个月VAS评分,A组显著优于B组,差异具有统计学意义(P<0.05)。结论经椎旁肌间隙入路治疗胸腰椎压缩性骨折具有操作简单、手术创伤小、治疗效果好、术后恢复优的特点,值得临床推广。Objective To observe the curative effect of approach through paravertebral muscle gap approach in the treatment of thoracolumbar compression fracture of vertebral body. Methods There were 42 patients with thoracolumbar compression fracture of vertebral body without spinal canal decompression, 21 cases of them received approach through paravertebral muscle gap approach（group A） and the other 21 cases received traditional posterior midline approach（group B）. Both groups received posterior short segment fixation, and their intraoperative condition and postoperative effects were analyzed and compared. Results Group A had much better operation time, incision length, and intraoperative bleeding volume than group B, and their difference had statistical significance（P〈0.05）. The two groups had similar Cobb angle correcting rate, and their difference had no statistical significance（P〈0.05）; the group B had obviously atrophicmultifidus muscle after operation. The difference had statistical significance（P〈0.05）. Group A had better VAS score in 1 month after operation than group B, and their difference had statistical significance（P〉0.05）. Conclusion Approach through paravertebral muscle gap approach in the treatment of thoracolumbar compression fracture of vertebral body has advantages of easy operation, small invasion, good effect and quick postoperative recovery. It is worthy of clinical promotion.

关 键 词：椎旁肌间隙入路 椎体压缩性骨折 胸腰段 

分 类 号：R687.3[医药卫生—骨科学]