摘要
目的:分析胸腰椎骨折选择经椎旁肌间隙入路术式治疗的临床疗效。方法:收集符合标准的胸椎腰椎骨折患者,经椎旁肌间隙入路术式患者48例与经皮置钉术式患者31例进行对比分析,测量两组患者术后切口总长度、术中软组织损伤程度、术中出血量及术前、术后1周、术后6个月伤椎前缘高度丢失率等指标,整理数据并通过统计学软件进行分析。结果:术前病例一般资料比较,差异无统计学意义(P>0.05),具有可比性;两组患者术前伤椎前缘高度丢失率比较,差异无统计学意义(P>0.05),具有可比性;组间比较时,术后1周和术后6个月伤椎前缘高度丢失率比较,差异有统计学意义(P<0.05),椎旁肌间隙入路组较经皮置钉组能够更好恢复椎体前缘高度;组内比较时,两组患者术后1周和术后6个月椎体前缘高度丢失率与术前比较,差异有统计学意义(P<0.05),两组患者均能较好复位伤椎前缘高度;两组患者术后6个月与术后1周椎体前缘高度丢失率比较,差异无统计学意义(P>0.05),术后患者伤椎前缘高度无明显丢失。两组切口总长度比较,差异有统计学意义(P<0.05),经皮置钉组切口总长度较椎旁肌间隙入路短。两组患者CK比较,差异有统计学意义(P<0.05),椎旁肌间隙入路较经皮置钉组软组织损伤小。两组患者术中出血量比较,差异无统计学意义(P>0.05),两组患者术中出血量无差异。结论:经椎旁肌间隙入路术式具有软组织损伤程度轻、出血少、并发症少等特点,是一种有效治疗无神经损伤的胸腰椎骨折的微创化术式选择。
Objective:To analyze the clinical effect of paraspinal space approach for thoracolumbar vertebral fracture.Methods:Patients with thoracolumbar vertebral fractures who met the criteria were compared and analyzed,and forty-eight patients were treated by paraspinal space approach pedical screw-rod fixation and thirty-one patients were treated by percutaneous pedical screw-rod fixation.The total length of the incision,the degree of soft tissue injury,the amount of bleeding during the operation were measured in the two groups,and the preoperative,1 week and 6 months after operation the injury vertebral leading edge height loss rate and other indicators were measured also.The recorded data was analyzed with statistical software.Results:There was no statistically significant difference in two groups of the general information and the loss of anterior vertebral edge height before surgery(P>0.05).When comparing between groups,the loss rate of anterior vertebral height of the injured vertebral at 1 week and 6 months after operation was compared the paraspinal space approach better than the percutaneous pedical screw-rod fixation(P<0.05).There was significant difference compared 1 week and 6 months after surgery with preoperative in every groups in the rate of loss of anterior vertebral edge height(P<0.05).The anterior margin of the injured vertebral could be better reset in two groups.The rate of vertebral anterior margin height loss was compared between the two groups postoperative 6 months and postoperative 1 week,there was no significant loss of anterior edge height postoperative(P>0.05).Total incision length was significantly shortened in percutaneous pedicle screw-rod fixation group as compared with it in the paraspinal space approach group(P<0.05).The soft tissue damage was significantly less in paraspinal space approach group as compared with it in the percutaneous pedicle screw-rod fixation by the CK(P<0.05).There was no difference in the intraoperative blood loss between the two groups(P>0.05).Conclusion:The paraspinal space approach is characterized by mild soft tissue injury,less bleeding and fewer complications,it is an effective minimally invasive surgical method for the treatment of thoracolumbar vertebral fracture without nerve injury.
作者
朱宝
赵继荣
张彦军
邓强
郭铁峰
ZHU Bao;ZHAO Jirong;ZHANG Yanjun;DENG Qiang;GUO Tiefeng(Gansu Province Hospital of Traditional Chinese Medicine,Lanzhou 730050,China.)
出处
《中国中医骨伤科杂志》
CAS
2020年第2期33-37,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
椎旁肌间隙入路
胸腰椎骨折
经皮置钉
微创
paraspinal approach
thoracolumbar vertebral fracture
percutaneous pedicle screw-rod fixation
minimally invasive surgery
