后路经肌间隙椎弓根螺钉内固定术与传统开放椎弓根螺钉内固定术治疗胸腰椎骨折脱位型损伤的临床疗效  

Clinical Effect of Posterior Transmuscular Pedicle Screw Internal Fixation and Traditional Open Pedicle Screw Internal Fixation in the treatment of Thoracolumbar Fracture and Dislocation Injury

作　　者：顾军[1] 孙小明 王俊[1] 罗爱华[1] 李宽新 GU Jun;SUN Xiaoming;WANG Jun(Xinjiang Production and Construction Corps Second Division Kurle Hospital Orthopaedics,Xinjiang Kule 841000,China)

机构地区：[1]新疆生产建设兵团第二师库尔勒医院,新疆库尔勒841000 [2]新疆生产建设兵团总医院,新疆乌鲁木齐830000

出　　处：《河北医学》2019年第11期1926-1929,共4页Hebei Medicine

基　　金：新疆维吾尔自治区自然科学基金,(编号:2014521L6354)

摘　　要：目的:分析后路经肌间隙椎弓根螺钉内固定术治疗胸腰椎骨折脱位型损伤的疗效。方法:收集行手术治疗的胸腰椎骨折脱位型损伤患者100例,按照手术方式将其分为后路经肌间隙椎弓根螺钉内固定术组(观察组,n=45)和传统手术组(传统组,n=55)。比较两组手术情况、术前、术后24h及末次随访时的疼痛程度、矫形影像学指标变化及ODI评分。结果:观察组术中出血量、术后引流量显著少于传统组,住院时间显著短于传统组(P<0.05);术后24h及末次随访时观察组VAS评分均显著低于传统组(P<0.05)两组术前及末次随访时矫形影像学指标比较无显著差异(P>0.05);末次随访时观察组ODI评分变化幅度大于传统组,差异有统计学意义(P<0.05)。结论:后路经肌间隙椎弓根螺钉内固定术治疗术中出血少,创伤小,可减少患者术后切口疼痛,促进其功能恢复。Objective:To explore the clinical efficacy of posterior transforaminal pedicle screw fixation and conventional open pedicle screw fixation on thoracolumbar fracture-dislocation injury.Methods:A total of 100 patients with thoracolumbar fracture-dislocation injury who underwent elective surgery were divided into observation group(posterior transforaminal pedicle screw fixation,n=45)and control group(traditional open pedicle screw fixation,n=55)according to the surgical procedures.The operation conditions and pain degree,orthopedic imaging indexes changes and Oswestry dysfunction index score(ODI)before operation,at 24h after operation and at the last follow-up were recorded and compared between the two groups.Results:There was no significant difference in the operative time between the two groups(P>0.05).The intraoperative blood loss and postoperative drainage volume in observation group were significantly less than those in control group,and the hospital stay was significantly shorter than that in control group(P<0.05).The VAS scores in observation group were significantly lower than those in control group at 24h after operation and at the last follow-up(P<0.05).There were no statistical differences in the orthopedic imaging indexes between the two groups before operation and at the last follow-up(P>0.05).At the last follow-up,the change range of ODI score in the observation group was larger than that in the traditional group(P<0.05).Conclusion:Posterior transmuscular pedicle screw fixation has less bleeding and less trauma,which can reduce incision pain and promote functional recovery.

关 键 词：胸腰椎骨折 后路经肌间隙 椎弓根螺钉内固定 开放手术 

分 类 号：R68[医药卫生—骨科学]