经椎旁肌间隙与经皮椎弓根螺钉固定胸腰段骨折的比较  

Comparison of fixation of thoracolumbar fractures between with screws through paraspinal muscle gap approach and percutaneous pedicle of vertebral arch

作　　者：刘琼 钟孝政[2] 

机构地区：[1]重庆市长寿区人民医院骨一科,重庆401220 [2]第三军医大学附属第三医院创伤外科

出　　处：《西南国防医药》2015年第12期1297-1299,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的 研究经椎旁肌间隙和经皮椎弓根螺钉固定治疗胸腰段骨折的效果。方法 2009年6月~2013年6月收治符合纳入标准的胸腰段骨折患者40例,随机分为两组,分别采用经椎旁肌间隙（A组）和经皮（B组）椎弓根螺钉固定,比较两组手术时间、术中出血量、术后引流量、术后卧床时间、术后住院天数、术后腰背痛VAS评分、腰椎JOA评分、伤椎后凸Cobb角及并发症等临床指标。结果 B组在手术时间、术中出血量、术后引流量、术后卧床时间、术后住院天数、术后腰背痛VAS评分上均明显优于A组（P〈0.05）,而两组在腰椎JOA评分、伤椎后凸Cobb角上没有统计学差异（P〉0.05）。结论 经皮椎弓根螺钉固定较经椎旁肌间隙入路治疗胸腰段骨折对患者的手术创伤少,术后恢复时间快,而手术效果相当。Objective To investigate the effects of fixation of thoracolumbar fractures between with screws through paraspinal muscle gap approach and percutaneous pedicle of vertebral arch. Methods 40 patients who suffered from thoracolumbar fractures between June 2009 and June 2013 and being in accordance with inclusion criteria were selected and divided into group A and B. Group A were treated by fixation with screws through paraspinal muscle gap approach, while group B were done by fixation with screws through percutaneous approach. Comparison was made in the operative time, perioperative blood loss and postoperative drainage, time in bed, time of hospitalization, and lumbodorsal pain VAS scores, and lumbar JOA scores, anterioposterial Cobb＇s angles of suffered vertebra, and complications between the two groups. Results Group B was significantly superior to group A in operative time, intraoperative blood loss, and postoperative drainage, time in bed and in hospital, and lumbodorsal pain VAS scores （P 〈 0.05）. The difference was not significant in lumbar JOA scores and anterioposterial Cobb＇s angles of suffered vertebra between the two groups（P 〉 0.05）. Conclusion Compared with paraspinal muscle gap approach, the percutaneous transpedicular screw fixation for the treatment of thoracolumbar fractures has the advantages of less surgical traumas, faster postoperative recovery time, and the same surgical effects.

关 键 词：胸腰段 骨折 椎旁 经皮 椎弓根螺钉 固定 

分 类 号：R683.2[医药卫生—骨科学]