经椎旁肌间隙与后正中入路治疗113例胸腰椎骨折的对比研究

Comparative study of approaches along lateral margin vs.medial part of the erector spinae for treatment of 113 cases of thoracolumbar fractures

目的比较经椎旁肌间隙入路和传统后正中切口入路治疗胸腰椎骨折的效果,为有效治疗胸腰椎骨折提供依据。方法回顾性分析2010年6月至2013年6月入院的113例胸腰椎骨折患者,分为两组,观察组55例,经椎旁肌间隙入路;对照组58例,经传统后正中切口入路。分别记录两组患者的手术时间、术中出血量、椎弓根螺钉置入满意度、术后感染情况和下腰痛Macnab标准评分值,并进行统计学分析。结果两组患者的手术时间、术中出血、椎弓根螺钉置入满意度和下腰痛评分差异具有统计学意义(P<0.05),观察组较对照组更有优势。结论经椎旁肌间隙入路是治疗胸腰椎骨折的一种良好入路方式,具有临床推广的价值。

Objective To compare the differences between the approaches along lateral margin and medial part of the erector spinae for treatment of thoracolumbar fractures,and provide evidence for a more effective treatment of thoracolumbar fractures.Methods The duration of operation,intraoperative blood loss,level of satisfaction of pedicle screw placement,postoperative infection,and lower back pain score of two approaches for treatment of thoracolumbar fractures were recorded.Statistical methods were used for analysis and comparison of differences between them.Results The duration of operation,intraoperative blood loss,level of satisfaction of pedicle screw placement,and lower back pain score showed significant differences between two surgical approaches（P〈0.05）.The approach along lateral margin of the erector spinae had advantages over the approach along medial part of the erector spinae for treatment of thoracolumbar fractures.Conclusion The approach along lateral margin of the erector spinae is a good way in treatment of thoracolumbar fractures,for less intraoperative blood loss,shorter duration of operation,higher level of satisfaction of pedicle screw placement,above 94% of lower back pain Macnab standard score,and satisfactory clinical effect.