经Wiltse肌间隙入路与后正中入路对单节段无神经症状胸腰椎骨折患者内固定术效果及功能恢复的影响  

Effects of Wiltse Intermuscular Approach and Posterior Median Approach on Internal Fixation and Functional Recovery in Patients with Singlesegment Thoracolumbar Fractures Without Neurological Symptoms

作　　者：韦振兑 郭伟杰 丁柱 WEI Zhendui;GUO Weijie;DING Zhu(Department of Orthopaedics,Shunde Peace Surgery Hospital,Foshan 528308,Guangdong,China)

机构地区：[1]顺德和平外科医院骨二区,广东佛山528308

出　　处：《系统医学》2024年第20期74-77,共4页Systems Medicine

摘　　要：目的分析经椎旁Wiltse肌间隙入路与后正中入路对单节段无神经症状胸腰椎骨折患者内固定术效果及功能恢复的影响。方法非随机选取2021年1月—2023年1月顺德和平外科医院收治的72例单节段无神经症状胸腰椎骨折患者作为研究对象,根据手术入路方式不同分为对照组(n=36)和观察组(n=36)。对照组采用经后正中入路治疗,观察组采用经Wiltse肌间隙入路治疗。对比两组患者围手术期情况、伤椎前缘高度比和Cobb角、功能恢复情况。结果观察组围手术期指标优于对照组,差异有统计学意义(P均<0.05)。观察组术后1周、术后12个月的伤椎前缘高度高于对照组、Cobb角低于对照组,差异有统计学意义(P均<0.05)。术后3、6、12个月,观察组Oswestry功能障碍指数评分分别为(26.64±3.78)分、(15.92±3.52)分、(7.62±1.37)分,低于对照组的(33.58±4.57)分、(20.65±4.33)分、(10.96±2.65)分,差异有统计学意义(t=7.021、5.086、6.718,P均<0.05)。结论与后正中入路相比,经Wiltse肌间隙入路治疗的围手术期指标更优,伤椎前缘高度比和Cobb角治疗效果及功能恢复情况更好。Objective To analyze the effect of Wiltse approach and posterior median approach on internal fixation and functional recovery in patients with single-segment thoracolumbar fractures without neurological symptoms.Methods From January 2021 to January 2023,seventy-two patients with single-segment thoracolumbar fractures without neuro-logical symptoms admitted to Shunde Peace Surgery Hospital were non-randomly selected and divided into control group(n=36)and observation group(n=36)according to different surgical approaches.The control group was treated by posterior median approach,and the observation group was treated by Wiltse muscle gap approach.The periopera-tive conditions,anterior vertebral height ratio,Cobb angle and functional recovery of the two groups were observed and compared.Results The perioperative indexes of the observation group were better than those of the control group,and the differences were statistically significant(all P<0.05).The anterior vertebral height ratio of the observation group was higher than that of the control group at 1 week and 12 months after operation,and the Cobb angle was lower than that of the control group,the differences were statistically significant(all P<0.05).The Oswestry disability index scores of the observation group were 26.64±3.78,15.92±3.52,and 7.62±1.37,which were lower than 33.58±4.57,20.65±4.33,and 10.96±2.65 of the control group,the differences were statistically significant(t=7.021,5.086,6.718,all P<0.05).Conclusion Compared with the posterior median approach,the perioperative indicators of the Wiltse in-termuscular approach were better,and the treatment effect and functional recovery of the anterior vertebral height ratio and Cobb angle were better.

关 键 词：椎旁肌间隙入路 后正中入路 单节段无神经症状胸腰椎骨折 内固定术 功能恢复 

分 类 号：R687.3[医药卫生—骨科学]