Objective:To study the vertebral body structure as well as the whole body and nerve injury after treatment of thoracolumbar fractures through paraspinal muscle approach and traditional approach.Methods:A total of 74 p...Objective:To study the vertebral body structure as well as the whole body and nerve injury after treatment of thoracolumbar fractures through paraspinal muscle approach and traditional approach.Methods:A total of 74 patients with thoracolumbar fractures who received surgical treatment in our hospital between September 2013 and October 2015 were selected and randomly divided into the paraspinal approach group and the median approach group who received the internal fixation surgery through paraspinal muscle approach and the internal fixation surgery through traditional median approach respectively. Before surgery as well as 3 months, 6 months after surgery, Cobb Angle was detected;before surgery as well as 1 d and 3 d after surgery, serum levels of creatase, stress hormones and nerve injury molecules were determined.Results:3 months, 6 months after surgery, the Cobb Angle of paraspinal approach group and median approach group were significantly lower than those before surgery and the Cobb Angle were not significantly different between the two groups of patients;serum LDH, CK, Myo, NE, E, Cor and Ins levels of both groups 1 d and 3 d after surgery were significantly higher than those before surgery and the serum LDH, CK, Myo, NE, E, Cor and Ins levels of paraspinal approach group were significantly lower than those of median approach group, serum NSE, S100B and GFAP levels of both groups 1 d and 3 d after surgery were significantly lower than those before surgery and serum NSE, S100B and GFAP levels of paraspinal approach group were significantly lower than those of median approach group. Conclusion: The vertebral body stability are equivalent after treatment of thoracolumbar fractures through paraspinal muscle approach and traditional approach, and the trauma extent of paraspinal muscle approach is less.展开更多
Objective: To study the muscle injury, inflammatory response and bone metabolism after paravertebral muscle space and minimally invasive percutaneous approach surgeries for thoracolumbar fracture. Methods: A total of ...Objective: To study the muscle injury, inflammatory response and bone metabolism after paravertebral muscle space and minimally invasive percutaneous approach surgeries for thoracolumbar fracture. Methods: A total of 92 patients with thoracolumbar fractures who were treated in Baoji Central Hospital between May 2015 and January 2017 were selected and randomly divided into paravertebral group and minimally invasive percutaneous group who accepted pedicle screw fixation under different approaches. Before operation as well as 1 d and 3 d after operation, serum was collected to determine the contents of creatase, inflammatory reaction molecules and bone metabolism indexes. Results: Serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, OC, OPG, PICP and PINP levels of both groups 1 d and 3 d after operation were significantly higher than those before operation while TRACP5b, RANKL, CTX and NTX levels were significantly lower than those before operation, and serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, TRACP5b, RANKL, CTX and NTX levels of paravertebral group 1 d and 3 d after operation were significantly lower than those of minimally invasive percutaneous group while OC, OPG, PICP and PINP levels were significantly higher than those of minimally invasive percutaneous group. Conclusion:Paravertebral muscle space surgery for thoracolumbar fracture is more effective than minimally invasive percutaneous surgery in reducing muscle injury and inflammatory response, and improving bone metabolism.展开更多
目的:探讨不同入路切开复位内固定术对胸腰椎压缩骨折(TCF)患者应激反应及疼痛程度的影响。方法:选取乐平市中医医院2021年1月—2022年2月收治的79例TCF患者,依据随机数字表法分为对照组(n=40)、研究组(n=39)。两组均行切开复位内固定术...目的:探讨不同入路切开复位内固定术对胸腰椎压缩骨折(TCF)患者应激反应及疼痛程度的影响。方法:选取乐平市中医医院2021年1月—2022年2月收治的79例TCF患者,依据随机数字表法分为对照组(n=40)、研究组(n=39)。两组均行切开复位内固定术,对照组经后正中入路,研究组经椎旁肌间隙入路。对比两组围手术期指标、应激反应指标[血清皮质醇(Cor)、前列腺素E_(2)(PGE_(2))]、术后疼痛程度[视觉模拟评分法(VAS)]、腰椎功能[Oswestry功能障碍指数(ODI)]及并发症发生情况。结果:研究组术中出血量、术后引流量均较对照组少,总住院时间较对照组短,差异均有统计学意义(P<0.05);研究组术后1 d Cor、PGE_(2)水平均较对照组低,差异均有统计学意义(P<0.05);研究组术后3、7 d VAS评分均较对照组低,术后6个月ODI评分较对照组低,差异均有统计学意义(P<0.05);两组并发症发生率对比,差异无统计学意义(P>0.05)。结论:相比后正中入路,TCF患者行经椎旁肌间隙入路切开复位内固定术可减少术中出血量与术后引流量,减轻机体应激反应,降低术后疼痛程度,利于腰椎功能恢复,且并发症少。展开更多
目的比较经椎旁肌间隙入路与后正中入路治疗胸腰椎骨折的临床疗效。方法对74例单节段胸腰椎骨折的患者实行后路椎弓根内固定治疗,按入路分为两组：椎旁肌间隙入路33例（A组）,后正中入路41例（B组）。对两组的手术时间、术中出血量、术...目的比较经椎旁肌间隙入路与后正中入路治疗胸腰椎骨折的临床疗效。方法对74例单节段胸腰椎骨折的患者实行后路椎弓根内固定治疗,按入路分为两组：椎旁肌间隙入路33例（A组）,后正中入路41例（B组）。对两组的手术时间、术中出血量、术后引流量、术前术后疼痛视觉模拟评分（VAS）、功能障碍指数（ODI）、术后住院时间、椎体高度矫正率、Cobb角矫正率进行比较分析。结果患者均获随访,时间12~36个月。两组椎体高度矫正率、Cobb角矫正率、末次随访时VAS和ODI比较差异均无统计学意义（P〉0.05）;两组手术时间、术中出血量、术后引流量、术后住院时间、术后7 d VAS和ODI比较A组优于B组,差异均有统计学意义（P〈0.01或P〈0.05）。结论经椎旁肌间隙入路治疗胸腰椎骨折具有出血少、创伤小、康复快等优点,适合治疗单节段胸腰椎骨折。展开更多
文摘Objective:To study the vertebral body structure as well as the whole body and nerve injury after treatment of thoracolumbar fractures through paraspinal muscle approach and traditional approach.Methods:A total of 74 patients with thoracolumbar fractures who received surgical treatment in our hospital between September 2013 and October 2015 were selected and randomly divided into the paraspinal approach group and the median approach group who received the internal fixation surgery through paraspinal muscle approach and the internal fixation surgery through traditional median approach respectively. Before surgery as well as 3 months, 6 months after surgery, Cobb Angle was detected;before surgery as well as 1 d and 3 d after surgery, serum levels of creatase, stress hormones and nerve injury molecules were determined.Results:3 months, 6 months after surgery, the Cobb Angle of paraspinal approach group and median approach group were significantly lower than those before surgery and the Cobb Angle were not significantly different between the two groups of patients;serum LDH, CK, Myo, NE, E, Cor and Ins levels of both groups 1 d and 3 d after surgery were significantly higher than those before surgery and the serum LDH, CK, Myo, NE, E, Cor and Ins levels of paraspinal approach group were significantly lower than those of median approach group, serum NSE, S100B and GFAP levels of both groups 1 d and 3 d after surgery were significantly lower than those before surgery and serum NSE, S100B and GFAP levels of paraspinal approach group were significantly lower than those of median approach group. Conclusion: The vertebral body stability are equivalent after treatment of thoracolumbar fractures through paraspinal muscle approach and traditional approach, and the trauma extent of paraspinal muscle approach is less.
文摘Objective: To study the muscle injury, inflammatory response and bone metabolism after paravertebral muscle space and minimally invasive percutaneous approach surgeries for thoracolumbar fracture. Methods: A total of 92 patients with thoracolumbar fractures who were treated in Baoji Central Hospital between May 2015 and January 2017 were selected and randomly divided into paravertebral group and minimally invasive percutaneous group who accepted pedicle screw fixation under different approaches. Before operation as well as 1 d and 3 d after operation, serum was collected to determine the contents of creatase, inflammatory reaction molecules and bone metabolism indexes. Results: Serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, OC, OPG, PICP and PINP levels of both groups 1 d and 3 d after operation were significantly higher than those before operation while TRACP5b, RANKL, CTX and NTX levels were significantly lower than those before operation, and serum Myo, CK, LDH, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, TRACP5b, RANKL, CTX and NTX levels of paravertebral group 1 d and 3 d after operation were significantly lower than those of minimally invasive percutaneous group while OC, OPG, PICP and PINP levels were significantly higher than those of minimally invasive percutaneous group. Conclusion:Paravertebral muscle space surgery for thoracolumbar fracture is more effective than minimally invasive percutaneous surgery in reducing muscle injury and inflammatory response, and improving bone metabolism.
文摘目的:探讨不同入路切开复位内固定术对胸腰椎压缩骨折(TCF)患者应激反应及疼痛程度的影响。方法:选取乐平市中医医院2021年1月—2022年2月收治的79例TCF患者,依据随机数字表法分为对照组(n=40)、研究组(n=39)。两组均行切开复位内固定术,对照组经后正中入路,研究组经椎旁肌间隙入路。对比两组围手术期指标、应激反应指标[血清皮质醇(Cor)、前列腺素E_(2)(PGE_(2))]、术后疼痛程度[视觉模拟评分法(VAS)]、腰椎功能[Oswestry功能障碍指数(ODI)]及并发症发生情况。结果:研究组术中出血量、术后引流量均较对照组少,总住院时间较对照组短,差异均有统计学意义(P<0.05);研究组术后1 d Cor、PGE_(2)水平均较对照组低,差异均有统计学意义(P<0.05);研究组术后3、7 d VAS评分均较对照组低,术后6个月ODI评分较对照组低,差异均有统计学意义(P<0.05);两组并发症发生率对比,差异无统计学意义(P>0.05)。结论:相比后正中入路,TCF患者行经椎旁肌间隙入路切开复位内固定术可减少术中出血量与术后引流量,减轻机体应激反应,降低术后疼痛程度,利于腰椎功能恢复,且并发症少。
文摘目的比较经椎旁肌间隙入路与后正中入路治疗胸腰椎骨折的临床疗效。方法对74例单节段胸腰椎骨折的患者实行后路椎弓根内固定治疗,按入路分为两组：椎旁肌间隙入路33例（A组）,后正中入路41例（B组）。对两组的手术时间、术中出血量、术后引流量、术前术后疼痛视觉模拟评分（VAS）、功能障碍指数（ODI）、术后住院时间、椎体高度矫正率、Cobb角矫正率进行比较分析。结果患者均获随访,时间12~36个月。两组椎体高度矫正率、Cobb角矫正率、末次随访时VAS和ODI比较差异均无统计学意义（P〉0.05）;两组手术时间、术中出血量、术后引流量、术后住院时间、术后7 d VAS和ODI比较A组优于B组,差异均有统计学意义（P〈0.01或P〈0.05）。结论经椎旁肌间隙入路治疗胸腰椎骨折具有出血少、创伤小、康复快等优点,适合治疗单节段胸腰椎骨折。
