后路经肌间隙入路内固定对胸腰椎骨折脱位患者VAS评分及影像学指标的影响

Effect of Posterior Intermuscular Space Approach Internal Fixation on VAS Score and Lmaging Indexes of Thoracolumbar Fracture and Dislocation

目的探讨后路经肌间隙入路内固定对胸腰椎骨折脱位患者疼痛(VAS)评分及影像学指标的影响。方法选取胸腰椎骨折脱位患者84例,采用抽签法进行分组,分为观察组(42例)和对照组(42例)。对照组采用传统开放入路方式治疗,观察组采用后路经肌间隙入路内固定方式治疗,术后,比较两组VAS评分、伤椎椎管通畅率、责任节段前柱高度百分比、Cobb角。结果术后5个月,观察组VAS评分较对照组低,差异有统计学意义(P<0.05);术后5个月两组伤椎椎管通畅率、责任节段前柱高度百分比、Cobb角水平均优于术前,差异有统计学意义(P<0.05)。结论较传统开放入路手术治疗对比,后路经肌间隙入路内固定治疗可有效减轻胸腰椎骨折脱位患者术后疼痛程度,改善伤椎椎管通畅率、责任节段前柱高度百分比、Cobb角,利于患者预后。

Objective To investigate the effect of posterior intermuscular space approach internal fixation on pain(VAS)score and imaging indexes in patients with thoracolumbar fracture and dislocation.Methods Eighty-four patients with thoracolumbar fracture and dislocation were selected and divided into observation group(42 cases)and control group(42 cases)by lottery method.The control group was treated with the traditional open approach,while the observation group was treated with the posterior approach through the intramuscular space approach.After surgery,VAS score,spinal canal patency rate of the injured vertebra,percentage of the height of the anterior column of the responsible segment,and Cobb Angle were compared between the two groups.Results Five months after surgery,VAS score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Five months after the operation,the injured vertebral canal patency rate,the percentage of the height of the front column of the responsible segment,and the level of Cobb Angle were all better than those before the operation,and the differences were statistically significant(P<0.05).Conclusion Compared with traditional open approach,posterior intermuscular approach internal fixation can effectively reduce postoperative pain in patients with thoracolumbar fracture and dislocation,improve the rate of spinal canal patency,percentage of responsible segment height of anterior column,and Cobb Angle,which is beneficial to the prognosis of patients.