经椎旁肌间隙入路治疗42例胸腰椎骨折的临床观察

Clinical observation of 42 cases of thoracolumbar fractures treated by paraspinal approach

目的探讨经椎旁肌间隙入路治疗胸腰椎骨折的效果。方法选取2015年8月~2016年8月在我院进行诊治的胸腰椎骨折患者84例,随机分为传统后正中入路组、经椎旁肌间隙入路组,比较两组的手术时间、术中出血量、术后引流量、感染情况、JOA腰背痛评分及不良反应。结果经椎旁肌间隙入路组患者手术时间、术中出血量、术后引流量均明显低于传统后正中入路组且均具有统计学意义(t=3.468、17.085、30.079,P<0.05),未发现两组感染情况具有统计学意义(χ~2=2.041,P=0.153),经椎旁肌间隙入路组患者JOA腰背痛评分明显高于传统后正中入路组且具有统计学意义(t=25.497,P<0.05)。结论经椎旁肌间隙入路治疗胸腰椎骨折效果显著,值得临床推广。

Objective To explore the effect of paraspinal approach in the treatment of thoracolumbar fractures. Methods 84 cases of thoracolumbar fracture in our hospital from August 2015 to August 2016 were selected and randomly divided into the traditional posterior approach group and paraspinal approach group.The operation time,intraoperative bleeding volume,postoperative drainage,infection,JOA low hack pain score and adverse reactions of the two groups were compared. Results The operation time,intraoperative bleeding volume,postoperative drainage patients in paraspinal approach group were obviously lower than those of the traditional posterior approach group. There had statistical differences （t=3.468,17.085,30.079,P 〈 0.05）.There was no statistical difference between the two groups with infection （X2=2.041,P=0. 153）.JOA low back pain score of paraspinal approach group was significantly higher than that of the traditional posterior approach group.There had statistically significant difference （t=25.497, P 〈 0.05）,and paraspinal approach had less adverse reactions. Conclusion The treatment of thoraeolumbar fracture by paraspinal approach is effective,and it is worthy of clinical promotion.