【摘要】 目的通过对椎旁肌入路联合后正中入路与传统后正中入路手术的比较,评价经椎旁肌入路联合后正中入路在胸腰椎骨折合并脊髓损伤手术中的疗效。方法回顾性分析自2009-02—2012-02诊治的具有完整随访资料的胸腰椎骨折合并脊髓损伤52例,分为2组,后正中入路手术组24例,椎旁肌入路联合后正中入路手术组28例。结果 52例获得18~36(26±4.5)个月的随访,椎旁肌入路联合后正中入路组在手术时间、术中及术后出血量、术后1周VAS评分评定疼痛改善情况方面优于后正中入路组,差异有统计学意义(P<0.05),而伤椎前后缘高度恢复、Cobb角矫正率以及神经功能恢复情况方面,差异无统计学意义(P>0.05)。结论椎旁肌入路联合后正中入路手术治疗胸腰椎骨折合并脊髓损伤的患者具有与后正中入路手术具有相同的疗效,且具有手术时间短、创伤小、出血量少、术后患者恢复快等优点。更多还原

【Abstract】 Objective To compare the clinical results between paraspinal approach combined with posterior midline approach and traditional posterior midline approach in treatment of thoracolumbar fractures with nerve injury. Methods From February2009 to February 2012, a total of 52 cases of thoracolumbar fractures with nerve injury were included in the study, which were divided into two groups, including 24 cases of posterior midline approach, 28 cases of paraspinal approach combined with posterior midline approach. Results All 52 patients were followed up for 18-36 months, with an average of(26 ±4.5)month.The paraspinal approach combined with posterior midline approach group had a better performance in operation time, blood loss in and after operation, and postoperative VAS score at first week(P <0.05). There were no significant differences in recovery of anterior and posterior vertebral body height, Cobb angle, and recovery of neurological function between the two groups(P >0.05). Conclusion Paraspinal approach combined with posterior midline approach in the treatment of thoracolumbar fractures with nerve injury has the same clinical effect as posterior midline approach. And it has the advantages of shorter operation time, less trauma, less blood loss at operation and post operation, and faster recovery after operation.更多还原