经椎旁肌间隙入路手术治疗胸腰椎骨折的效果及对患者远期功能恢复的影响探讨  

Effect of surgical treatment of thoracolumbar fractures through paravertebral muscle approach and its influence on long-term functional recovery of patients

作　　者：潘宗旺 PAN Zong-wang(Third Department of Orthopedics,Jianping County Hospital,Chaoyang 122400,China)

机构地区：[1]建平县医院骨外三科,122400

出　　处：《中国实用医药》2021年第12期28-31,共4页China Practical Medicine

摘　　要：目的探究经椎旁肌间隙入路手术治疗胸腰椎骨折的效果以对远期功能恢复的影响。方法 68例胸腰椎骨折患者,根据随机数字表法分为对照组和观察组,各34例。两组均采用椎弓根螺钉内固定术治疗,对照组采用传统入路,观察组采用经椎旁肌间隙入路。对比两组患者不同时间段疼痛情况及治疗前后影像学指标、功能障碍指数、日常生活能力。结果术后3、6 d,观察组视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,两组椎体前缘高度比值大于治疗前,后凸Cobb角小于治疗前,功能障碍指数低于治疗前,差异有统计学意义(P<0.05);两组椎体前缘高度比值、后凸Cobb角比较差异均无统计学意义(P>0.05);观察组功能障碍指数低于对照组,差异有统计学意义(P<0.05)。治疗后6个月,观察组日常生活能力量表(ADL)评分(64.08±3.47)分和日本骨科协会(JOA)评分(7.86±1.25)分均高于对照组的(53.14±4.20)、(5.65±1.42)分,差异有统计学意义(P<0.05)。结论经椎旁肌间隙入路手术治疗胸腰椎骨折的效果良好,可减轻患者术后疼痛,椎体稳定性良好,有利于远期功能恢复,值得推广。Objective To investigate the effect of paravertebral muscle approach in the treatment of thoracolumbar fractures and its influence on long-term functional recovery of patients.Methods A total of 68 patients with thoracolumbar fractures were divided into control group and observation group according to random numerical table,with 34 cases in each group.Both groups underwent pedicle-screw internal fixation.The control group used traditional approach,and the observation group used paravertebral muscle approach.The pain status at different time points,imaging indexes,dysfunction index and activities of daily living before and after treatment were compared between the two groups.Results 3 and 6 d after surgery,the visual analogue scale(VAS)score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).6 month after treatment,the anterior vertebral height ratio of the two groups were greater than those before treatment,kyphosis Cobh angle was smaller than those before treatment,and dysfunction index were lower than those before treatment.All the difference was statistically significant(P<0.05).There was no statistically significant difference in anterior vertebral height ratio and kyphosis Cobh angle between the two groups(P>0.05).The dysfunction index of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).6 months after treatment,the activities of daily living(ADL)score(64.08±3.47)points and Japan Orthopedic Association(JOA)score(7.86±1.25)points of the observation group were higher than(53.14±4.20)and(5.65±1.42)points of the control group,and the difference was statistically significant(P<0.05).Conclusion Surgical treatment of thoracolumbar fractures through paravertebral muscle approach has good effect,which can reduce patients*postoperative pain with a good stability of vertebral body,and is conducive to long-term functional recovery.It is worthy of promotion.

关 键 词：胸腰椎骨折 经椎旁肌间隙入路 椎弓根螺钉内固定术 远期功能恢复 

分 类 号：R687.3[医药卫生—骨科学]