摘要
目的评价经多裂肌椎旁肌间隙入路结合伤椎置钉短节段固定技术在胸腰椎骨折内固定手术治疗中的临床疗效。方法对71例无需椎管减压的胸腰椎骨折患者从后路行短节段内固定手术,传统后正中入路伤椎不置钉27例(A组),采用椎旁肌间隙入路伤椎置钉44例(B组),分别记录两组的术后1周和术后1年伤椎Cobb角矫正率、椎体坍塌矫正率、疼痛感觉程度评分(VAS)。对两组的手术效果进行比较。结果所有胸腰椎骨折均骨性愈合,无出现内固定物松动、断钉断棒;两组术后1周伤椎Cobb角矫正率、椎体坍塌矫正率、VAS评分差异无统计学意义(P>0.05),术后1年的Cobb角矫正率、椎体坍塌矫正率、VAS评分两组间比较差异有统计学意义(P<0.01)。结论椎旁肌间隙入路内固定手术创伤小、入路简单、术后遗留腰疼并发症少,伤椎置钉技术有助于骨折椎体复位,增加固定节段稳定性,减少后凸畸形的发生。
Objective To investigate the clinical efficacy of injured vertebral screw fixation for thoracolumbar fractures via paraspinal muscle gap approach. Methods From January 2010 to October 2015,71 thoracolumbar fracture patients without spinal decompression received short segment internal fixation via posterior approach, including 27 cases of posterior midline approach without injured vertebral screw fixation （group A）and 44 cases of paraspinal approach with injured vertebral screw fixation （group B）. Both groups were evaluated by VAS score, correction rate of the Cobb angle, and correction rate of the vertebral collapse. Results All patients got bony union without internal fixation loosening, broken nails or broken rods. There were no significant differences in correction rate of the Cobb angle, correction rate of the vertebral collapse and postoperative VAS score between the groups at the time point of 1 - week after surgery（P 〉 0.05 ）. However, there were significant differences in those results at the time point of 1-year after surgery （P 〈 0.05 ）. Conclusion Internal fixation via paraspinal muscle gap approach has the advantages of less trauma, simple approach, and limited complications. It helps to restore the fractures, stabilize the segments and prevent kyphosis, which is worthy of being spread.
出处
《临床外科杂志》
2016年第6期463-466,共4页
Journal of Clinical Surgery
关键词
椎旁肌间隙入路
胸腰椎骨折
经伤椎固定
内固定
paraspinal muscle gap approach
thoracolumbar fractures
injured vertebral fixation
internal fixation
