体位复位结合椎旁肌间隙入路治疗胸腰椎骨折

Hyperexlension Position Combined with Pedicle Screw Fixation Via Paraspinal Approach for the Treatment of Thorocolumbar Fractures

目的探讨体位复位结合直视下椎旁肌间隙入路椎弓根螺钉治疗单节段无神经症状的不稳定胸腰椎骨折的临床疗效。方法 2008年6月至2010年12月,采用体位复位结合直视下椎旁肌间隙入路椎弓根螺钉固定治疗单节段无神经症状的不稳定胸腰椎骨折20例,并与开放手术相比较。结果两组手术时间、术中出血量、术后引流量、住院时间、带支具离床时间比较椎旁肌间隙入路组优于开放组,差异有统计学意义(P<0.01);而伤椎椎体前缘高度百分比两组比较差异无统计学意义(P>0.05)。结论体位复位结合直视下椎旁肌间隙入路椎弓根螺钉技术具有创伤小、出血少、术中透视少、术后恢复快等优点,是治疗单节段无神经症状的胸腰椎骨折的有效方法。

Objective To summarize the clinical effect of hyperexlension position combined with pedicle screw fixation via paraspinal approach for the treatment of unstable thorocolurnbar fractures. Methods From June 2008 to December 2010, 20 cases of single segment without neurological symptoms of unstable thoracolurnbar fractures were treated with hyperexlension position combined with pedicle screw fixation via paraspinal approach. The minimally in- vasive group was compared with the treatment of conventional open pedicle screws fixation in other patients. Results All the patients were followed up for an average time of 16 months（range 10~21 months）. The operation time and length of in-hospital time in paraspinal approach group were significantly shorter than that in open fixation group,the amount of operative bleeding and drainage of postoperation decreased obviously. The differences were statistical sig- nificance （P〈0.01）. There was no significant difference in anterior vertebra height between two groups （P〈0. 05）. Conclusion The technique of hyperexlension position combined with pedicle screw fixation via paraspinal approach has the advantages of less trauma and bleeding,short operation time and quick recovery.