后路棘旁双切口单节段椎弓根钉固定治疗胸腰椎骨折

Treatment of thoracolumbar fracture by posterior paramedian approach monosegmental pedicle screw internal fixation

目的探讨后路双侧棘旁切口肌间隙入路，单节段椎弓根钉内固定治疗胸腰椎骨折的临床疗效。方法自2008年12月-2010年12月采用后路双侧棘旁切口肌间隙入路、切开复位单节段椎弓根钉内固定治疗胸腰椎骨折加例。结果本组术后X线片测量骨折椎前缘压缩百分比从术前（42．0±3．2）％恢复至（7．9±1．1）％（P〈0．05）；骨折椎后凸畸形Cobb角从术前（24．1±3．1）o恢复至（5．1±1．2）°（P〈O．05）。所有患者获随访7—27个月，患者腰背部疼痛均明显改善，骨折均于术后3个月愈合．无内固定失败、断裂和松动。结论后路双侧棘旁切口肌间隙人路、切开复位单节段椎弓根钉固定可以有效治疗胸腰椎骨折．但应严格掌握手术适应证。

Objective To analyze the results of posterior paramedian approach monosegmental pedicle screw internal fixation in treatment of thoracolumbar vertebral fractures. Methods From 2008 to 2010, 40 cases of thoracolumbar vertebral fractures were treated surgically. All eases were treated by posterior paramedian approach monosegmental pedicle screw internal fixation. Results All eases had no neurovascular complications and failure of internal fixation. Bone fusion of fractures reached after 3 months. There were restoration of anterior body compression from mean preoperative （42.0±3.2）% to （7.9±1.1）% （P 〈0.05）, and restoration of Cobb angle from mean preoperative （24.1±3.1）°to postoperative （5.1±1.2）°（P 〈0.05）. Conclusion Posterior para- median approach monosegmental pedicle screw internal fixation in treatment thoracolumbar vertebral fractures is a feasible technique, if indication is correctly chosen.