经椎旁肌间隙入路、伤椎置钉内固定直接复位骨折间接椎管减压治疗胸腰段爆裂性骨折的效果观察  

Clinical effect of indirect decompression of vertebral canaland direct reduction of fracture through paravertebral muscle space approach and internal fixation with screw through fractured vertebrain the treatment of thoracolumbar burst fractures

作　　者：曾红生 陈子华[1] 邹伟龙 陈建威[1] 陈鑫营 ZENG Hong-sheng;CHEN Zi-hua;ZOU Wei-long;CHEN Jian-wei;CHEN Xin-ying(Department of Orthopedics,Heyuan Hospital Affiliated to Jinan University(Heyuan People's Hospital),Heyuan 517000,China)

机构地区：[1]暨南大学附属河源医院(河源市人民医院)骨一科,广东河源517000

出　　处：《广东医科大学学报》2021年第2期170-172,共3页Journal of Guangdong Medical University

摘　　要：目的观察经椎旁肌间隙入路、伤椎置钉内固定直接复位骨折间接椎管减压胸腰段爆裂性骨折的效果。方法将123例胸腰椎爆裂性骨折患者随机分为观察组(61例)和对照组(62例)。观察组采用经椎旁肌间隙入路伤椎置钉直接复位骨折间接椎管减压。对照组患者行后正中入路、伤椎置钉进行复位手术,椎板开窗直接椎管减压。记录两组的椎管狭窄率、伤椎前缘压缩率、Cobb角、视觉模拟(VAS)评分等指标。术后每3个月复查1次脊柱X线片,随访6个月,比较两组的疗效、并发症发生情况。结果观察组的疗效优于对照组(P<0.01)。两组术后的椎管狭窄率、伤椎前缘压缩率、Cobb角、VAS评分等均明显低于术前(P<0.01);而观察组术后VAS评分明显低于对照组(P<0.01),两组术后的椎管狭窄率、伤椎前缘压缩率、Cobb角差异无统计学意义(P>0.05)。观察组的并发症发生率明显低于对照组(P<0.01)。结论经椎旁肌间隙入路伤椎置钉间接椎管减压用于胸腰段爆裂性骨折治疗的临床效果好,并发症发生率低,值得临床推广应用。Objective To observe the clinical effect of indirect decompression of vertebral canal and direct reduction of fracture through paravertebral muscle space approach and internal fixation with screw through fractured vertebra in the treatment of thoracolumbar burst fractures.Methods 123 patients with thoracolumbar burst fractures were randomly divided into the Observation Group(61 cases)and the Control Group(62 cases).The Control Group received fracture reduction through the posterior approach and fixation with screw through fractured vertebra and direct decompression of the spinal canal while Observation Group received indirect decompression of vertebral canal and direct reduction of fracture through paravertebral muscle space approach and internal fixation with screw through fractured vertebra.The spinal stenosis rate,compression ratio of anterior injured vertebra,Cobb angle and VAS score of the two groups were recorded.The spine X-ray was conducted once every three months after the operation and followed up for 6 months.The clinical effects and typical complications of the two groups were compared.Results The curative effect of the Observation Group was better than that of the Control Group(P<0.01).The postoperative spinal stenosis rate,compression ratio of anterior injured vertebra,Cobb angle and VAS score of the two groups were significantly lower than those before operation(P<0.01);the posto-perative VAS score of the Observation Group was significantly lower than that of the Control Group(P<0.01).There was no significant difference in the postoperative spinal stenosis rate,anterior compression rate of injured vertebra and Cobb angle between the two groups(P>0.05).The incidence of complications in the Observation Group was significantly lower than that in the Control Group(P<0.01).Conclusion The indirect decompression of vertebral canal and direct reduction of fracture through paravertebral muscle space approach and internal fixation with screw through fractured vertebra shows good clinical effect in the treatm

关 键 词：肌间隙入路 钉棒内固定术 胸腰椎爆裂性骨折 间接椎管减压 

分 类 号：R683[医药卫生—骨科学]