【摘要】 目的比较经椎旁肌间隙入路与后正中入路治疗胸腰椎骨折的临床疗效。方法对74例单节段胸腰椎骨折的患者实行后路椎弓根内固定治疗,按入路分为两组:椎旁肌间隙入路33例(A组),后正中入路41例(B组)。对两组的手术时间、术中出血量、术后引流量、术前术后疼痛视觉模拟评分(VAS)、功能障碍指数(ODI)、术后住院时间、椎体高度矫正率、Cobb角矫正率进行比较分析。结果患者均获随访,时间12~36个月。两组椎体高度矫正率、Cobb角矫正率、末次随访时VAS和ODI比较差异均无统计学意义(P>0.05);两组手术时间、术中出血量、术后引流量、术后住院时间、术后7 d VAS和ODI比较A组优于B组,差异均有统计学意义(P<0.01或P<0.05)。结论经椎旁肌间隙入路治疗胸腰椎骨折具有出血少、创伤小、康复快等优点,适合治疗单节段胸腰椎骨折。更多还原

【Abstract】 Objective To compare the effect of pedicle screw fixation of thoracolumbar fractures via trans-paraspinal muscles approach and the conventional posterior midline approach. Methods 74 cases of single-level thoracolumbar fractures were subjected to single posterior pedicle screw fixation and reduction. Among the patients,33 cases were operated through trans-paraspinal muscles approach( group A) and 41 cases through posterior midline surgical approach( group B). The following date were compared:operation time,intraoperative blood loss,postoperative drainage volume,postoperative hospital stay,pre-and post-operative pain degree( visual analogue scale,VAS),Oswestry disability index( ODI),correct rate of vertebral body height and Cobb angle. Results All cases were followed up for 12 ~ 36 months. There were no statistical differences between the two groups in aspects of correct rate of vertebral body height,Cobb angle,postoperative VAS and ODI of the latest follow-up( P > 0. 05); Operation time,intraoperative blood loss,postoperative draining loss,postoperative hospital stay,VAS points and ODI points in group A at 7 d after operation showed statistical differences from those in group B( P < 0. 01 or P < 0. 05),group A was superior to group B. Conclusions Trans-paraspinal muscles approach is characterized by less bleeding,minor trauma,and quick recovery as compared with conventional posterior midline approach and hence may be the preferred choice for the treatment of single-level thoracolumbar fracture.更多还原