经椎旁肌间隙入路椎弓根钉棒系统置入内固定治疗胸腰椎爆裂骨折：与传统方法比较

Paraspinal muscle approach pedicle screw-rod system fixation for the treatment of thoracolumbar burst fractures:Compared with conventional approach

背景:采用经椎旁肌间隙入路应用于胸腰椎爆裂骨折的手术治疗实现了经椎旁肌间隙入路行椎弓根钉棒植入及整复固定。目的:比较经椎旁肌间隙入路与传统后正中入路手术治疗胸腰椎爆裂骨折的临床疗效。方法:纳入53例无明显神经损伤且后凸大于20°和/或椎体前缘高度塌陷大于50%的胸腰椎爆裂骨折患者。分别采用经椎旁肌间隙入路(n=28)及传统后正中入路(n=25)进行治疗。结果与结论:与传统后正中入路比较,经椎旁肌间隙入路治疗的患者疼痛目测类比评分明显降低(P<0.05),而在伤椎Cobb角改善、椎体前缘高度恢复和椎管正中矢径变化方面两组差异无显著性意义(P>0.05)。说明经椎旁肌间隙入路内固定治疗胸腰椎爆裂骨折可以达到与传统后正中入路治疗相同的效果,且可促进患者功能恢复。

BACKGROUND： Paraspinal muscle approach for the treatment of thoracolumbar burst fracture makes it possible for pedicle screw-rod implantation and fixation through paraspinal muscle approach. OBJECTIVE： To compare the clinical effect of paraspinal muscle approach and conventional approach for the treatment of thoracolumbar burst fracture. METHODS： Fifty-three patients who suffered from thoracolumbar burst fractures without obvious nerve injury were included; all the patients were injured with kyphosis greater than 20 and/or anterior vertebral height collapse larger than 50%. The patients were treated with paraspinal muscle approach （n=28） and conventional approach （n=25） respectively RESULTS AND CONCLUSION： The visual analog scale of the patients treated with paraspinal muscle approach was significantly decreased when compared with the patients treated with conventional approach （P 〈 0.05）. There was no significant difference in the radiographic results （Cobb angle, height of anterior edge of the fractured vertebrae and midsagital diameter of the fractured spinal canal） between two groups （P 〉 0.05）. Paraspinal muscle space approach fixation can reach the same effect with conventional approach for the treatment of thoracolumbar burst fractures, and can promote functional recovery.