Paraspinal approach for thoracolumbar fracture

目的将由解剖学习和临床的申请探索 paraspinal 途径的优点和指示。解剖数据和 27 个盒子的临床的实践被分析探索在 paraspinal 肌肉和周围的纸巾的结构之间的精确途径的方法，以及 paraspinal 的临床的申请的结果来临。操作时间，血损失，切口长度， X 光线照相术的结果(Cobb 角度， vertebrae 的前面的边的高度) 与在传统的途径对待的 24 种情况中的那些相比。结果完成方面的暴露能被识别在 multifidus 和 longissimus 肌肉之间的自然劈开飞机容易执行。自然肌肉发达的劈开是(1.

Objective： To explore the advantages and indications of the paraspinal approach by anatomical study and clinical application.Methods： The anatomical data and clinical practice of 27 cases were analyzed to explore the accurate approach between the paraspinal muscles and the structure of ambient tissues, as well as the results of clinical application of paraspinal approach. The operation time, blood loss, incision length, radiographic result （Cobb angle, height of anterior edge of the vertebrae） were compared with those in 24cases treated by traditional approach.Results： Complete exposure of the facets could be easily performed by identifying natural cleavage plane between the multifidus and Iongissimus muscles. The natural muscular cleavage was （1.47±0.23） cm lateral to the midline for females, and （1.64±0.35） cm for males at T12 level. The distance was （3.3±0.6） cm lateral to the midline for females,and （3.7±1.0） cm for males at L4 level. In paraspinal approach group, the operation time was （76.2±15.7） min, blood loss was （91.6±16.9） ml and incision length was （7.6±0.8） cm. In traditional approach group, the operation time was （121.4±19.6） min, blood loss was （218.7±32.3 ） ml and incision length was （17.4±2.1） cm. To compare paraspinal approach with traditional approach, the operation time, blood loss and incision length had statistical difference （P〈0.05） and the radiographic result （Cobb angle, height of anterior edge of the vertebrae） had no statistical difference （P〉0.05）.Conclusions： When the paraspinal approach is performed through natural cleavage plane between the multifidus and longissimus muscles, there are no wide muscular disinsertions, leaving the supraspinous and interspinous ligaments intact. The distance of natural cleavage to the midline is different at T12 and L4 planes. By this approach,the facet joints can be explored easily and completely, and a clear surgical field will be available for the placement of pedicle screws. As a minimally invasive approach, it can be widely used in thoracolumbar spine surgery.