椎旁肌间隙入路与后正中入路椎弓根螺钉内固定治疗胸腰椎骨折的临床观察  

Clinical observation of therapeutic effect of pedicle screw fixation via paravertebral muscle space approach and posterior median approach in treatment of thoracolumbar vertebral fracturehu

作　　者：朱朝均[1] 陶建宏[1] 陈翔[1] 唐发兵[1] 蒋华健 杨松运[1] 安明和[1] 莫松全[1] ZHU Chao-jun;TAO Jian-hong;CHEN Xiang(The Santai Peopled Hospital of Mianyang 621100)

机构地区：[1]三台县人民医院,四川绵阳621100

出　　处：《中国伤残医学》2019年第10期23-24,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:研究探讨椎旁肌间隙入路手术与后正中入路椎弓根螺钉内固定治疗胸腰椎骨折临床治疗效果。方法:选择三台县人民医院2016年4月-2018年4月住院的52例胸腰椎骨折患者,所选患者均采用了椎弓根螺钉内固定手术治疗。我们根据手术入路选择不同,分为观察组共26例,采用椎旁肌间隙入路,对照组共26例,采用后正中手术入路,比较这2种手术入路方式的出血量、手术时间、引流量、住院时间、伤椎高度.Cobb角和疼痛视觉模拟评分的差异。结果:观察组的所需手术时间、术中出血量、术后引流量、住院总时间和对照组比较,观察组占有明显优势(P<0.05)。2组患者伤椎高度.Cobb角矫正度及VAS评分术后均明显优于术前(P值<0.05);2组间术后伤椎前缘高度.Cobb角、疼痛视觉模拟评分相比,P值均<0.05,有统计学意义。结论:椎旁肌间隙手术入路所需时间较少、术后功能恢复较快,它与后正中入路手术相比,具有创伤较小、损伤较小特点,并且腰背部疼痛不适在术后缓解比较明显,值得在临床工作中大量推广。Objective: To investigate the therapeutic effect of pedicle screw fixation paravertebral muscle space approach and posterior median approach in the treatment of thoracolumbar vertebral fracture. Methods: Fifty Two cases of thoracolumbar vertebral fractures were selected in Santai peoples hospital from Apr. 2014 to Apr. 2018 , who were treated by pedicle screw fixation ( PSF). According to the choice of surgical approach, 26 patients were divided into the observation group, and 26 patients in the control group were used in the control group, and the posterior median surgical approach was adopted to compare the difference in the amount of bleeding, operation time, lead flow, length of hospitalization, injury height, Cobb Angle and pain visual simulation score of the two surgical approaches. Results: The operation time, bleeding volume, postoperative drainage rate and hospital stay of the control group were significantly lower than those in the observation group( P <0. 05). In the two groups, the height of the injured vertebral body and the Cobb angle after operation were significantly better than those before operation( P <0. 05), but there was no significant difference in the height of the anterior edge, Cobb angle and VAS between the two groups after operation( P >0. 05). Conclusion: Compared with the posterior median approach, paravertebral muscle space approach for treating thoracolumbar vertebral fractures has advantages of short operation time, rapid functional recovery, less trauma,less surgical injury, and obvious pain relief of postoperative lumbar back pain, which was worth to be widely applied in clinical practice.

关 键 词：胸腰椎骨折 椎弓根螺钉 内固定 椎旁肌间隙手术入路 后正中入路手术 

分 类 号：R683.1[医药卫生—骨科学]