胸腰椎骨折患者经椎旁肌间隙入路手术治疗临床分析.docVIP

胸腰椎骨折患者经椎旁肌间隙入路手术治疗临床分析 　　【摘要】 目的：探讨经椎旁肌间隙入路手术在治疗胸腰椎骨折上的临床应用价值及疗效。方法：选取笔者所在医院2008年5月-2012年10月收治的65例单节段胸腰椎压缩性或爆裂性骨折但无神经症状的患者，应用后路短节段椎弓根钉棒系统撑开复位内固定手术治疗，按手术入路方式的不同分为两组：A组（椎旁肌间隙入路组）（n=30）和B组（传统后正中入路组）（n=35）。比较两组患者的手术时间、术中出血量、术后引流量、椎体塌陷矫正率、术后疼痛感觉VAS评分、Oswestry功能障碍指数（ODI），分析评价两组的临床效果。结果：经椎旁肌入路组的平均手术时间、出血量、术后引流量、术后24 h及72 h疼痛感觉VAS评分均低于传统后正中入路组，两组比较差异均有统计学意义（P0.05）。结论：对于无神经症状不需要行椎管减压手术的胸腰椎骨折患者，椎旁肌间隙入路较传统后正中入路操作方便，创伤小，手术时间短，出血少等优势，减少了对椎旁肌结构和功能的影响，有利于患者早期康复。 　　【关键词】 胸腰椎骨折； 椎旁肌间隙入路； 后正中入路 　　中图分类号 R683 文献标识码 A 文章编号 1674-6805（2015）29-0014-03 　　Clinical Analysis of Surgical Treatment of the Thoracolumbar Fractures under the Posterior Paraspinal Muscle Approach/ZHANG Hong-xiang，MA Chao，LI Fu-bin，et al.//Chinese and Foreign Medical Research，2015，13（29）：14-16 　　【Abstract】 Objective： To discuss the clinical value and effects of surgical treatment of the thoracolumbar fractures under the posterior paraspinal muscle approach.Method：65 cases of single segment thoracolumbar compression or burst fractures without neurological symptoms underwent posterior short-segment pedicle screw fixation reduce system with surgery treatment were selected from May 2008 to October 2012 in our hospital，which were divided into two groups according to the surgical approach：A group（paraspinal muscle approach group）（n=30）and B group（the conventional middle approach group）（n=35）.The operative time，blood loss，postoperative drainage，vertebral collapse correction rate，postoperative pain sensation VAS score，Oswestry Disability Index（ODI） were evaluated，and analysized the clinical effects.Result：The paraspinal muscle approach had statistically significant advantages（P0.05） in terms of vertebral collapse correction rate，one week after feeling pain VAS scores，Oswestry disability index.Conclusion：The technique of operating through an approach between the paraspinal muscle is simple and recommended for patients with thoracolumbar fractures with non-neurological symptoms，because it is much less invasive，less time，