椎旁肌肌间隙入路联合伤椎椎弓根螺钉内固定治疗无神经损伤胸腰椎骨折  

Paraspinal approach in combined with pedicle screw fixation treatment of thoracolumbar vertebral fracture with no nerve damage

作　　者：卢苇[1] 杨飞[1] 哈秀民[1] 曹国栋[1] 许艳春[2] 

机构地区：[1]北京大学第三医院延庆医院骨科,北京102100 [2]中国人民解放军第251医院,河北张家口075000

出　　处：《长春中医药大学学报》2016年第2期358-359,共2页Journal of Changchun University of Chinese Medicine

基　　金：北京军区医疗成果项目(2009229)

摘　　要：目的观察经椎旁肌肌间隙入路伤椎置钉短节段椎弓根螺钉内固定对单节段无神经损伤胸腰椎骨折的治疗效果。方法选取单节段胸腰椎骨折患者13例,采用椎旁肌间隙入路伤椎置钉短节段椎弓根螺钉内固定治疗,观察患者术后伤椎矢状面Cobb角、伤椎椎体前缘高度、疼痛、脊柱功能和并发症发生情况。结果本组患者手术均顺利完成,术后均获1年随访,切口甲级愈合;术后伤椎矢状面Cobb角均较术前明显缩小,手术前后比较差异有统计学意义(P<0.05);术后伤椎椎体前缘高度较术前明显增高(P<0.05);术后VAS评分及ODI均较术前明显下降(P<0.05)。治疗过程中均无感染、内固定松动或断裂等并发症发生。结论经椎旁肌肌间隙入路伤椎置钉短节段椎弓根螺钉内固定能有效纠正单节段胸腰椎骨折伤椎前缘高度,纠正后凸畸形,不良反应少。Objective To observe the efficacy of paraspinal approach in combined with pedicle screw fixation in the treatment of thoracolumbar vertebral fracture with no nerve damage. Methods A total of 13 patients with single segmental thoracolumbar vertebral fracture were treated with paraspinal approach in combined with pedicle screw fixation. The postoperative injured vertebral sagittal plane Cobb angle,the injured vertebral front edge height,pain,spinal function,and complications were observed. Results The operations were successful. One- year follow up visit was paid to all the patients. The wounds were healed at the first grade. The postoperative injured vertebral sagittal plane Cobb angle was significantly lessened when compared with before operation（ P〈0. 05）. The postoperative injured vertebral front edge height was significantly increased when compared with before operation（ P〈0. 05）. The postoperative VAS score and ODI were significantly reduced when compared with before operation（ P〈0. 05）. No complications of infection,and internal fixation loosening or breaking were occurred. Conclusion The paraspinal approach in combined with pedicle screw fixation can effectively correct the injured vertebral front edge height of single segmental thoracolumbar vertebral fracture,and rectify the kyphosis,with less adverse reactions.

关 键 词：脊柱骨折 胸椎 腰椎 椎弓根螺钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]