比较经椎旁肌间隙入路与传统开放入路置入椎弓根螺钉治疗胸腰椎骨折的疗效

The comparison of paraspinal approach and traditional open approach treatment for thoracolumbar fractures with fixation using pedicle screw

目的比较经椎旁肌间隙入路与传统开放入路置入椎弓根螺钉治疗胸腰椎骨折临床疗效。方法自2008年7月～2010年7月,选取胸腰椎骨折患者87例,分成经椎旁肌间隙入路置入椎弓根螺钉组40例和传统开放入路置入椎弓根螺钉组47例。记录并比较两组手术时间、术中出血量、术毕切口内残腔体积、术后引流量、伤椎Cobb角纠正率、术后腰背痛VAS评分等指标。结果治疗胸腰椎骨折经椎旁肌间隙入路组与传统手术入路组比较,伤椎Cobb角纠正率无明显差异,手术时间、术中出血量、术毕切口内残腔体积、术后引流量、术后腰背痛VAS评分差异有统计学意义(P<0.05)。结论经椎旁肌间隙入路置入椎弓根螺钉治疗胸腰椎骨折减少椎旁肌的骨性剥离,缩短手术时间,减少术中出血量、切口内残腔体积及术后引流量,明显减轻术后慢性腰背痛。

[ Objective] To assess the surgical therapeutic result of thoracolumbar fracture by pediele screw fixation through paraspinal approach or traditional open approach. [ Methods ] 87 thoracolumbar fracture patients were divided into two groups： 40 cases were included in the paraspinal approach group and 47 cases were in the traditional open approach group. The perioperative index and postoperative VAS score was compared. [ Results] There were significant differences in the surgical time, surgical blood loss, dead space size, surgical draining loss and VAS score between the two groups .The efficacy of the two surgical approach are the same. [ Conclusions] The treatment for thoraeolumbar fractures through paraspinal approach can cut down the stripping of the paraspinal muscle, so this method can reduce dead space size, surgical draining loss and lumbago and back pain.