椎旁肌间隙入路与传统后正中入路治疗胸腰段椎体骨折的比较研究

Comparison between paraspinal approach and conventional approach for thoracolumbar vertebraI fracture

目的比较椎旁肌间隙入路与传统后正中入路治疗胸腰段椎体骨折的临床疗效。方法回顾性分析2004年1月～2011年10月60例无神经症状无须减压的胸腰椎骨折患者,按手术入路方式的不同分为2组:椎旁肌间隙入路19例(A组);传统后正中入路41例(B组)。比较2组的手术时间、术中出血量、疼痛视觉模拟量表(visual analogue scale,VAS)评分及椎体高度矫正率等各项临床指标。结果 A组手术时间、出血量和VAS疼痛评分优于B组,差异有统计学意义(P<0.05);而椎体高度矫正率2组间比较差异无统计学意义(P>0.05)。结论经椎旁肌间隙入路方式与传统后正中入路显露方式比较,具有术者操作简单、创伤小、出血少、术后患者恢复快等优点。

Objective To compare clinical outcolne of the operative approaches of thoracolumbar fractures between paraspinal approach and conventional approach. Methods From January 21304 to October 2011, a total of 60 patients suffering from thoracolumbar fractures without nerve injury underwent surgical treatment. Nineteen cases were treated by pedicle screw fixation through paraspinal approach （ Group A） and 41 eases were treated through conventional approach （ Group B）. The following data were compared between 2 groups： operation time, bleeding, visual analogue seale （VAS） seores and correction rate of vertebral height.Results There were statistically significant differences in operation time, bleeding and VAS scores between 2 groups but no significant difference in correction rate of vertebral height. Conclusion The technique of operative treatment through the paraspinal approach has advantages of simpler procedures, less trauma and bleeding and quicker recovery.