经椎旁肌间隙行后路椎弓根螺钉内固定术治疗胸腰椎骨折的效果观察

Efficacy observation of posterior paraspinal muscle pedicle screw fixation in treatment of thoracolumbar fractures

目的评价经椎旁肌间隙行后路椎弓根螺钉内固定术治疗胸腰椎骨折的临床效果。方法选取2012年3月～2013年11月本院收治的胸腰椎骨折患者78例,将其随机分为观察组和对照组,其中观察组42例采用经椎旁肌间隙行后路椎弓根螺钉内固定术,对照组36例采用传统术式,观察并比较两组的手术时间、术中出血量、术后引流量、伤椎Cobb角矫正率、椎体塌陷矫正率与拆除内固定后腰椎JOA评分。结果观察组手术时间为（54.6±7.7）min,术中出血量为（113.4±5.8）ml,术后引流量为（53.2±6.1）ml,JOA评分为（25.3±1.0）分;对照组手术时间为（87.3±9.9）min,术中出血量为（312.3±13.1）ml,术后引流量为（363.8±16.9）ml,JOA评分为（19.3±0.6）分;两组患者手术时间、术中出血量、术后引流量、JOA评分比较,差异有统计学意义（P〈0.01）。结论经椎旁肌间隙行后路椎弓根螺钉内固定术治疗胸腰椎骨折能有效降低患者手术负荷,临床疗效与传统方法相同,术后疼痛较轻,值得临床推广应用。

Objective To evaluate the clinical efficacy of the posterior paraspinal muscle pedicle screw fixation in the treatment of thoracolumbar fractures. Methods 78 cases of patients with thoracolumbar fracture admitted to hospital from March 2012 to November 2013 were selected.They were randomly divided into observation group（42 cases） and control group（36 cases）.The posterior paraspinal muscle pedicle screw fixation was given to the observation group,the traditional operation was given to the control group.The operative time,blood loss,postoperative drainage,correction rate of injured vertebra Cobb angle,the correction rate of vertebral collapse and the JOA score after fixed lumbar′s removal of the two groups were observed and compared. Results The operation time of the observation group was（54.6±7.7）min,blood loss was（113.4±5.8） ml,postoperative drainage was（53.2±6.1） ml,JOA score was（25.3±1.0） points;the operation time of the control group was（87.3±9.9） min,blood loss was（312.3±13.1） ml,postoperative drainage was（363.8±16.9） ml,JOA score was（19.3±0.6） points;the operation time,blood loss,postoperative drainage and the JOA scores of two groups had significant difference（P〈0.01）. Conclusion Posterior paraspinal muscle pedicle screw fixation for the treatment of thoracolumbar fractures can effectively reduce the surgery load of the patients.It has the same clinical efficacy and less postoperative pain to the traditional methods,is worthy to be promoted in clinical practice.