椎旁肌间隙入路与后正中入路对短节段胸腰椎骨折的疗效比较

Comparison of the effect of paraspinal muscle approach and posterior median approach on short segmental thoracolumbar fractures

目的:比较由椎旁肌间隙入路治疗短节段胸腰椎骨折与通过后正中入路治疗的临床疗效。方法 :选择胸腰椎单节段,需手术治疗且无神经症状、无需减压的椎体骨折35例,分为后正中入路组及椎旁肌间隙组,比较两组术后Cobb角纠正率、止痛药物使用情况、疼痛视觉模拟评分、外周血肌酸激酶水平及手术时间、术中出血、术后引流量、隐性失血和总出血量。结果:两组Cobb角的纠正率基本相似,椎旁肌间隙组手术时间、总出血量、隐性失血、术中出血、术后引流量、术后外周血肌酸激酶水平及止痛药物使用量均少于后正中入路组(P<0.05)。结论:经椎旁间隙入路治疗短节段胸腰椎骨折具有可减少手术时间,减少围术期出血,减少止痛药物用量,降低医疗费用等优点。

Objective： To compare the efficacy of the treatment of short-segment thoracolumbar fractures with the paravertebral muscle space approach and the posterior median approach. Methods： Selecting the patients with a single segment of the thoracolumbar region requires surgery, and who have no symptoms of nerve damage and do not need spinal decompression. Divided these into posterior median approach group and paraspinal muscle space group. Comparing postoperative Cobb angle correction rate, analgesic drug use, strong opioid usage, pain visual analogue scale, peripheral blood creatine kinase level, operation time, intraoperative bleeding, postoperative drainage, recessive blood loss and total blood loss. Results： The recovery rates of Cobb angles in the two groups were basically similar. The operation time, the total amount of bleeding, the recessive blood loss, the intraoperative blood loss, the postoperative drainage, the postoperative peripheral blood creatine kinase level, and the use of analgesic drug were obviously decreased in the paraspinal muscle gap group. The difference was statistically significant. Conclusion： It recommended for the treatment of short-segment thoracolumbar fracture through the paravertebral space approach to reduce the operation time, reduce perioperative bleeding, promote rehabilitation, reduce the dosage of analgesics, and reduce medical expenses.