【摘要】 [目的]探讨经皮椎弓根穿刺技术结合椎旁肌间隙入路治疗胸腰椎骨折的手术方法及其与传统手术方法的疗效差异。[方法]将无神经损伤的112例胸腰椎骨折患者按照不同治疗路径分为治疗组和对照组,各56例。治疗组采用经皮椎弓根穿刺技术结合椎旁肌间隙入路,对照组为不采用经皮椎弓根穿刺技术的传统正中切口入路,记录两组患者手术时间、术中出血量、Coob角矫正度、术后引流量、住院天数;记录术前术后VAS评分;术后随访6个月。[结果]两组患者手术过程顺利,术中、术后生命体征平稳,术后均无并发症发生,骨折复位良好;手术时间、Coob角矫正度、住院天数无明显差异(P>0.05);但治疗组患者术中出血量及术后引流量均明显小于对照组(P<0.05)。随访6个月,患者术后疼痛缓解方面明显优于对照组,差异具有统计学意义(P<0.05);Macnab功能标准评价,两组术后疗效差异有统计学意义(P<0.05)。[结论]经皮椎弓根穿刺技术结合椎旁肌间隙入路手术方式,其手术入路操作简单、置钉容易,术中出血少、术后疼痛轻,是一种适合基层医院骨科应用的手术改良方式。更多还原

【Abstract】 [Objective] To explore the difference between the traditional operation and the one of percutaneous vertebral pedicle puncture combined with paravertebral muscle gap passage in treating thoracolumbar vertebral fracture. [Method] Divide 112 cases of thoracolumbar vertebral fracture without nerve injury into treatment and control groups under different therapy, n =56 for each. The treatment group takes percutaneous vertebral pedicle puncture combined with paravertebral muscle gap passage, the control one doesn’t take the traditional median incision passage, record both groups operation time,intraoperative bleeding amount, Coob angle correction degree, post-operation drainage, in-hospital days, as well as VAS score before and after operation;and follow up them after 6m. [Result] Both groups had smooth operation course, with stable life signs during and after operation, without complications,with good fracture reposition after operation; on operation time, Coob angle correction degree and in-hospital days, there’s no marked difference;however the in-operation bleeding amount and post-operation drainage in treatment group were mush less than control one; after 6m of following up,the pain relieve was better in treatment group than other one, with difference of statistical meaning; with Macnab standard functional evaluation, there’s statistical meaning on cure effect of both groups after operation. [Conclusion] The operation method of percutaneous vertebral pedicle puncture combined with paravertebral muscle gap passage is simple in operation, easy of installing nails, with little bleeding and lighter pain after operation, being an improved operation fit for orthopaedics department of basic hospitals.更多还原