Quadrant通道下经肌间隙入路内固定治疗脊柱爆裂性骨折的效果及对神经功能指标的影响

Effect of Intramuscular Internal Fixation Under Quadrant Channel in the Treatment of Spinal Burst Fracture and Its Effect on Neurological Indexes

目的观察Quadrant通道下开展经肌间隙入路内固定治疗脊柱爆裂性骨折的效果。方法选取2017至2019年丹阳市人民医院接收的78例脊柱爆裂性骨折患者为对象,均行Quadrant通道下开展经肌间隙入路内固定治疗。分析术后患者的术中出血量、手术时间、住院时间,术后副反应,以及手术开展前后患者的神经功能恢复情况、Cobb角、VAS评分和骨折椎前缘高度比、JOA评分。结果患者术中出血量为(141.17±21.49)ml,手术时间为(98.11±9.24)min,住院时间为(6.78±1.05)d。术后副反应:伴间歇性腰背痛1例,伴肺部感染1例。术后患者神经功能恢复情况优于术前(P<0.05)。术前患者的Cobb角大于术后,VAS评分高于术后,骨折椎前缘高度比低于术后(P<0.05)。术前患者JOA评分低于术后(P<0.05)。结论对脊柱爆裂性骨折患者选择实施Quadrant通道下开展经肌间隙入路内固定治疗,效果佳,具有恢复快、创伤小等优势,操作便捷,可有效降低患者术后疼痛感,促进神经功能、腰椎功能恢复。

Objective Taking patients with burst fractures of the spine as the object,the effects of transmuscular approach internal fixation under the Quadrant channel were analyzed and observed.Methods A total of 78 patients with spinal burst fractures received in Danyang People’s Hospital from January 2017 to 2019 were selected as subjects,and the selected cases were treated under the Quadrant channel to carry out transmuscular approach internal fixation.To explore and analyze the amount of intraoperative blood loss,operation time,hospital stay,postoperative side effects,and the recovery of neurological function of patients before and after the operation,Cobb angle,VAS score,ratio of fractured vertebral anterior height,JOA score.Results The patient’s intraoperative blood loss was(141.17±21.49)ml,the operation time was(98.11±9.24)min,and the hospital stay was(6.78±1.05)days.Among the postoperative side effects,there was 1 case with intermittent low back pain and 1 case with lung infection.Taking before and after surgical treatment as the judgment time,in the comparison of neurological function recovery,the neurological function recovery of postoperative patients was due to preoperative(P<0.05).The Cobb angle of preoperative patients was greater than that of postoperative patients,the VAS score was higher than that of postoperative patients,and the ratio of the height of the anterior edge of the fractured vertebrae was lower than that of postoperative patients(P<0.05).In the comparison of JOA scores,the results of preoperative data scores were lower than those of postoperative patients(P<0.05).Conclusion For patients with spinal burst fractures,choose to implement transmuscular approach internal fixation under the Quadrant channel.The effect is good,it has the advantages of fast recovery,less trauma,and convenient operation,which can effectively reduce the patient’s postoperative pain,promote nerve function,and lumbar spine Functional restoration.