椎旁肌间隙入路结合伤椎椎体内植骨治疗胸腰椎骨折  

Paraspinal Intermuscular Approach Combined with Bone Grafting in Injured Vertebra in Treatment of Thoracolumbar Fractures

作　　者：魏东[1] 唐雪彬[1] 刘征 刘加元[1] 李华[1] 岳喜军[1] 

机构地区：[1]徐州医学院第二附属医院骨科,江苏省徐州市221006 [2]日照市中医院

出　　处：《医学理论与实践》2015年第24期3325-3327,共3页The Journal of Medical Theory and Practice

摘　　要：目的：探讨经椎旁肌间隙入路结合伤椎椎体内植骨治疗胸腰椎骨折的方法和效果。方法：选取36例胸腰椎骨折患者,经椎旁肌间隙入路,结合伤椎经椎弓根椎体内植骨来治疗胸腰椎骨折。记录手术时间、术中失血量、术后切口引流量、手术前后疼痛视觉模拟评分（VAS）、伤椎前缘平均高度比值、脊柱后凸Cobb角等资料。术后指导患者腰背肌功能锻炼,1周后戴腰围下床活动。结果：手术平均时间94.5min;术中平均失血量139.2ml;术后平均切口引流量82.5ml。术后36例患者均获得了随访（6-15个月）,平均随访时间12.3个月。术后VAS、伤椎前缘平均高度比值、脊柱后凸Cobb角较术前得到明显改善,差异有统计学意义。所有骨折均得到复位,后凸得到矫正,无内固定失败、腰痛等并发症。结论：经椎旁肌间隙入路结合伤椎椎体内植骨治疗胸腰椎骨折可以减轻对椎旁肌肉软组织损伤,增加伤椎椎体的骨量及椎体的抗压稳定性,具有创伤小、恢复快等优点。Objective：To evaluate the method and effect for treatment of thoracolumbar fractures through paraspinal intermuscular approach with bone grafting in injured vertebra.Methods：A total of 36 patients who suffered from thoracolumbar fractures received surgical treatment.Operation time,blood loss,postoperative drainage,visual analog scale（VAS）scores,anterior vertebral height ratio and Cobb angle were record.All patients were instructed to formed some muscular activities after operation.One week later,patients were allowed to get out of bed with waist orthosis.Results：The average operation time is 94.5min.The average blood loss is 139.2ml.The average postoperative drainage is82.5ml.All patients were followed up for average 12.3months（range,6-15months）.There is a significant difference（P〈0.05）before and after operation in analog scale（VAS）scores,anterior vertebral height ratio and Cobb angle.All the fracture was reduced and the kyphosis was corrected,with no failure of internal fixation,back pain and other complications.Conclusion：The method that paraspinal intermuscular approach combined with bone grafting in injured vertebra can decrease invasive for muscle and soft tissue,increase vertebral body bone mass and vertebral compression stability,with the advantages of less trauma and faster recovery.

关 键 词：椎旁肌间隙入路 椎体植骨 胸腰椎骨折 

分 类 号：R683.2[医药卫生—骨科学]