经椎旁肌间隙入路与微创经皮入路手术治疗胸腰椎骨折的效果比较

Comparison of effect of thoracic and lumbar spine fractures treated by paraspinal muscle approach and minimally invasive percutaneous approach surgery

目的比较胸腰椎骨折患者接受经椎旁肌间隙入路与微创经皮入路手术治疗的效果及关节功能。方法回顾性分析2014年4月-2015年10月在该院接受内固定手术治疗的胸腰椎骨折患者,根据手术入路不同分为椎旁入路组和经皮微创组,分别接受经椎旁肌间隙入路与微创经皮入路手术治疗。比较两组患者的手术情况、围手术期血清创伤分子含量以及远期功能恢复情况和矫正畸形效果。结果椎旁入路组的手术时间明显短于经皮微创组,差异有统计学意义(P<0.05);术中出血量、术后引流量、术后卧床时间、住院总时间与经皮微创组比较,差异均无统计学意义(P>0.05);两组患者术后当天的血清肌酸激酶(CK)、肌红蛋白(Myo)和乳酸脱氢酶(LDH)含量比较,差异均无统计学意义(P>0.05),术后3、6和12个月时的伤椎前后缘高度比、Cobb角、视觉模拟评分(VAS)比较,差异均无统计学意义(P>0.05)。结论椎旁肌间隙入路与微创经皮入路手术治疗胸腰椎骨折的效果和创伤程度相当,椎旁肌间隙入路的手术操作更为简单、手术时间更短。

Objective To compare the effect and joint function of thoracic and lumbar spine fractures patients received paraspinal muscle approach and minimally invasive percutaneous approach surgery.Methods thoracic and lumbar spine fractures patients received internal fixation treatment from April 2014 to October 2015 were retrospectively analyzed and divided into paraspinal approach group and minimally invasive percutaneous approach group,separately received paraspinal muscle approach and minimally invasive percutaneous approach surgery.The operation condition,serum levels of traumatic molecules in the perioperative period and long-term functional recovery were observed.Results The operation time of paraspinal approach group was significantly shorter than the minimally invasive percutaneous approach group,intraoperative hemorrhage volume and postoperative drainage volume,postoperative bed time,hospitalization time have no significant difference with minimally invasive percutaneous approach group.serum CK,Myo and LDH contents of two groups patients after surgery had no significant difference;height ratio of anterior and posterior injured vertebra,Cobb angle and VAS score of two groups patients in 3 months,6 months and 12 months after surgery had no significant difference.Conclusion Curative effect and trauma degree of paraspinal muscle approach and minimally invasive percutaneous approach surgery are equivalent and paraspinal muscle approach surgery’s procedure is more simple,operative time is shorter.