经椎旁肌间隙入路椎弓根螺钉内固定治疗胸腰椎骨折的临床效果

Clinical Effect of Pedicle Screw Internal Fixation through Paravertebral Space Approach for Thoracolumbar Fracture

目的探讨经椎旁肌间隙入路椎弓根螺钉内固定治疗胸腰椎骨折的临床效果.方法选择我院2021年1月—2022年12月收治的78例胸腰椎骨折患者为研究对象,按随机数字表法将其分为对照组与观察组,两组患者均采用椎弓根钉内固定,对照组(n=39)采用正中入路,观察组(n=39)采用经椎旁肌间隙入路.比较两组手术指标,评估手术前后疼痛程度与胸腰椎功能及伤椎椎体结构,并统计并发症发生率.结果观察组手术时间(77.58±8.46)min短于对照组,观察组出血量(155.42±22.58)mL﹑引流量(76.31±15.24)mL均少于对照组,组间差异有统计学意义(P<0.05);术后,观察组疼痛视觉模拟评分(2.25±0.62)分﹑Oswestry功能障碍指数(28.64±2.84)分均低于对照组,观察组伤椎前缘高度比(82.37±5.28)%大于对照组,后凸Cobb角(6.36±1.15)°小于对照组,组间差异有统计学意义(P<0.05);观察组并发症发生率5.13%低于对照组的20.51%,差异有统计学意义(P<0.05).结论对胸腰椎骨折椎弓根螺钉内固定治疗时采用经椎旁肌间隙入路操作简单,对机体损伤小,术后疼痛轻且胸腰椎功能与结构恢复好,可降低并发症风险.

Objective To investigate the clinical effect of pedicle screw internal fixation through paravertebral space in the treatment of thoracolumbar fracture.Methods 78 patients with thoracolumbar fractures admitted to our hospital from January 2021 to December 2022 were selected as the research objects,and they were divided into a control group and an observation group according to the random number table method.All patients in the two groups were treated with pedicle screw internal fixation.The control group(n=39)was treated by median approach,and the observation group(n=39)was treated by paraspinal muscle space approach.Degree of pain assessment before and after surgery and thoracolumbar function and vertebral vertebral body structure,and complications of statistics.Results The operation time of the observation group was(77.58±8.46)min shorter than that of the control group,the bleeding volume of the observation group was(155.42±22.58)mL,and the drainage volume was(76.31±15.24)mL,which were less than those of the control group,the differences between the two groups were statistically significant(P<0.05);after surgery,the observation group Visual Analogue pain Scale score(2.25±0.62)points,Oswestry disability index(28.64±2.84)points are lower than the control group,the observation group injured vertebral leading edge height ratio(82.37±5.28)%greater than the control group,protruding after Cobb Angle(6.36±1.15)°less than the control group,there were significant differences between groups(P<0.05);the incidence of complications in the observation group 5.13%was lower than 20.51%in the control group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of thoracolumbar fractures with pedicle screw internal fixation,the paraspinal muscle space approach is simple to operate,with less damage to the body,less postoperative pain,better recovery of thoracolumbar function and structure,and can reduce the risk of complications.