经椎旁肌间隙入路椎弓根螺钉内固定手术治疗胸腰椎骨折的疗效研究  

Therapeutic effect of pedicle screw fixation via paraspinal intermuscular approach in the treatment of thoracolumbar fractures

作　　者：杨希亮 YANG Xi-liang(Yanggu County Hospital of Traditional Chinese Medicine,Liaocheng 252300,China)

机构地区：[1]阳谷县中医院,252300

出　　处：《中国实用医药》2022年第16期81-84,共4页China Practical Medicine

摘　　要：目的探究胸腰椎骨折应用经椎旁肌间隙入路椎弓根螺钉内固定手术治疗的临床效果。方法60例胸腰椎骨折患者,按照治疗方式不同分为对照组和研究组,各30例。对照组采用传统胸腰椎后侧正中切口入路跨伤椎置钉技术治疗,研究组患者采用经椎旁肌间隙入路椎弓根螺钉内固定手术治疗。比较两组患者手术时间、住院时间、术后下床活动时间、术中出血量、不良事件发生情况及视觉模拟评分法评分(VAS)评分、腰椎功能评分。结果研究组患者手术时间(66.31±1.29)min、住院时间(9.00±2.21)d、术后下床活动时间(3.05±1.26)d均短于对照组的(79.53±2.35)min、(12.29±3.26)d、(5.40±1.63)d,术中出血量(154.23±69.62)ml少于对照组的(540.31±105.6)ml,差异有统计学意义(P<0.05)。研究组不良事件发生率6.67%低于对照组的43.33%,差异有统计学意义(P<0.05)。研究组患者VAS评分(2.61±0.15)分低于对照组的(3.70±0.31)分,腰椎功能评分(19.23±2.32)分高于对照组的(17.30±2.20)分,差异有统计学意义(P<0.05)。结论对胸腰椎骨折患者应用经椎旁肌间隙入路椎弓根螺钉内固定手术治疗效果显著,可有效改善患者腰椎功能,促进患者早日下床活动,且术后不良事件少,值得临床推广。Objective To investigate the clinical effect of pedicle screw fixation via paraspinal intermuscular approach in the treatment of thoracolumbar fractures.Methods 60 patients with thoracolumbar fractures were divided into a control group and a study group based on different treatment methods,with 30 cases in each group.Patients in the control group were traditionally treated with the screw fixation across injured vertebra via thoracolumbar posterior median incision approach;while patients in the study group were treated with pedicle screw fixation via paraspinal intermuscular approach.The operation time,hospital stay,postoperative ambulation time,intraoperative bleeding amount,incidence of adverse events,visual analogue scale(VAS)score and lumbar function score were compared between the two groups.Results The study group had an operation time of(66.31±1.29)min,a hospital stay of(9.00±2.21)d,and a postoperative ambulation time of(3.05±1.26)d,which were shorter than(79.53±2.35)min,(12.29±3.26)d,(5.40±1.63)d of the control group,respectively;the intraoperative bleeding amount of the study group was(154.23±69.62)ml,which was less than(540.31±105.6)ml of the control group;and the differences were statistically significant(P<0.05).The incidence of adverse events in the study group was 6.67%,which was lower than 43.33%in the control group,and the difference was statistically significant(P<0.05).The study group had a VAS score of(2.61±0.15)points,which was lower than(3.70±0.31)points of the control group;while the study group had a lumbar function score of(19.23±2.32)points,which was higher than(17.30±2.20)points of the control group;and the differences were statistically significant(P<0.05).Conclusion The pedicle screw fixation via paraspinal intermuscular approach shows significant therapeutic effects in the treatment of thoracolumbar fractures.It can effectively improve the lumbar function and bring an early ambulation to patients with a low incidence of postoperative adverse events.Thus,it is worthy of prom

关 键 词：经椎旁肌间隙入路 椎弓根螺钉内固定 胸腰椎骨折 不良事件 

分 类 号：R687.3[医药卫生—骨科学]