椎旁肌间隙入路有限减压椎弓根钉内固定对脊髓损伤型胸腰椎骨折患者术后疼痛程度及Cobb角前缘高度的影响

Effects of Wiltse approach limited decompression pedicle screw internal fixation on postoperative pain and Cobb angle and leading edge height in patients with spinal cord injury thoracolumbar fractures

目的探讨椎旁肌间隙入路有限减压椎弓根钉内固定在脊髓损伤型胸腰椎骨折患者中的应用效果.方法将93例脊髓损伤型胸腰椎骨折患者根据治疗方案不同分为实验组47例,对照组46例,分别施行椎旁肌间隙入路有限减压椎弓根钉内固定、后正中入路全推板减压椎弓根钉内固定,术后观察72 h.比较两组术中出血量、手术时间、术后下地时间;于术前及术后72 h采用视觉模拟评分法评估两组患者疼痛程度,检测伤椎前缘高度、Cobb角,随时记录术后72h并发症发生情况.结果实验组术中出血量显著少于对照组,术后下地时间显著早于对照组(P<0.01),术后72 h视觉模拟评分法评分显著低于对照组(P<0.01);手术时间、术后72 h伤椎前缘高度、Cobb角及并发症发生率与对照组比较差异均无统计学意义(P>0.05).结论脊髓损伤型胸腰椎骨折患者施行椎旁肌间隙入路有限减压椎弓根钉内固定术,可减少术中出血量,缓解疼痛,缩短康复进程.

Objective To explore the effect of limited decompression pedicle screw internal fixation through the Wiltse approach in the treatment of patients with thoracolumbar spinal cord injury fracture.Methods 93 patients with thoracolumbar spine fracture of spinal cord injury were selected and divided into experimental group(47 cases)and control group(46 cases)according to the treatment plan.All the patients were treated with posterior midline decompression pedicle screw internal fixation and Wiltse limited decompression pedicle screw internal fixation respectively.Patients were observed for 72 hours after operation.The amount of bleeding,the operation time,the time to go to the ground after operation of the two groups were compared.Visual analogue scoring was used to assess the pain of the two groups of patients before and 72 hours after operation,and the height of the anterior vertebrae of injury and the Cobb angle were measured.The incidence of complications at 72 hours after operation was recorded at any time.Conclusions Limited decompression and pedicle screw fixation through Wiltse approach can reduce the amount of bleeding,relieve pain and shorten the rehabilitation process in patients with thoracolumbar spinal cord injury.