不同入路减压内固定术对胸腰椎爆裂骨折患者椎管占位率及神经功能的影响  

Effect of Different Approach Decompression and Internal Fixation on Spinal Canal Occupying Rate and Nerve Function in Patients with Thoracic and Lumbar Spine Bursting Fracture

作　　者：周英勇 卢奇昊 吉光荣 池开宇[1] ZHOU Yingyong;LUQihao;JI Guangrong;CHI Kaiyu(Department of Orthopedics and Traumatology,Xiamen Hospital of TCM,Xiamen 361015,China;不详)

机构地区：[1]厦门市中医院骨伤科,福建厦门361015

出　　处：《中国医学创新》2024年第20期137-141,共5页Medical Innovation of China

摘　　要：目的:比较不同入路减压内固定术中对胸腰椎爆裂骨折患者椎管占位率及神经功能的影响。方法:选取厦门市中医院2019年1月—2023年1月收治的80例胸腰椎爆裂骨折患者作为研究对象,根据手术入路不同分为后正中组和椎旁肌组,每组40例。后正中组实施后正中入路减压内固定术,椎旁肌组实施经椎旁肌间隙入路减压内固定术。比较两组手术指标、椎体压缩率、后凸Cobb角、日常生活活动量表(ADL)评分、视觉模拟评分法(VAS)评分、椎管占位率、脊髓神经功能分级。结果:椎旁肌组手术时间较后正中组短,术中失血量较后正中组少(P<0.05)。两组住院时间及术后椎体压缩率、后凸Cobb角、椎管占位率、脊髓神经功能分级比较,差异均无统计学意义(P>0.05)。椎旁肌组术后ADL评分较后正中组高,VAS评分较后正中组低(P<0.05)。结论:后正中入路、经椎旁肌间隙入路减压内固定术均可有效恢复胸腰椎爆裂骨折患者椎体高度,降低后凸Cobb角、椎管占位率,改善脊髓神经功能,但经椎旁肌间隙入路具有耗时短、术中出血少、术后疼痛感轻的优点。Objective:To compare the effect of different approach decompression and internal fixation on spinal canal occupying rate and nerve function in patients with thoracic and lumbar spine bursting fracture.Method:A total of 80 patients with thoracic and lumbar spine bursting fracture admitted to Xiamen Hospital of TCM from January 2019 to January 2023 were selected as the study objects,and were divided into posterior median group and paravertebral muscle group according to different surgical approaches,with 40 cases in each group.The posterior median group was treated with posterior median approach decompression and internal fixation,and the paravertebral muscle group was treated with transparavertebral muscle space approach decompression and internal fixation.The surgical indexes,vertebral compression ratio,kyphotic Cobb angle,activities of daily living scale(ADL)score,visual analogue scale(VAS)score,spinal canal occupying rate and spinal nerve function grade were compared between the two groups.Result:The operation time of paravertebral muscle group was shorter than that of posterior median group,and the intraoperative blood loss was less than that of posterior median group(P<0.05).There were no significant differences in hospital stay and after surgery of vertebral compression ratio,kyphotic Cobb angle,spinal canal occupying rate and spinal nerve function grade between the two groups(P>0.05).The ADL score of paravertebral muscle group after surgery was higher than that of posterior median group,and the VAS score was lower than that of the posterior median group(P<0.05).Conclusion:Both the posterior median approach and the transparavertebral muscle space approach decompression and internal fixation can effectively restore the vertebral height in patients with thoracic and lumbar spine bursting fracture,reduce the kyphotic Cobb angle and spinal canal occupying rate,and improve spinal nerve function.However,the transparavertebral muscle space approach has the advantages of short time,less intraoperative bleeding,and l

关 键 词：减压内固定术 后正中入路 经椎旁肌间隙入路 胸腰椎爆裂骨折 椎管占位率 神经功能 

分 类 号：R687.3[医药卫生—骨科学]