96例经椎旁肌间隙入路伤椎植骨内固定治疗胸腰椎爆裂性骨折的临床疗效观察

目的：对经椎旁肌间隙入路伤椎植骨内固定治疗胸腰椎爆裂性骨折患者的临床治疗效果进行观察和分析。方法：从本院自2008年9月-2012年3月收治的所有胸腰椎爆裂性骨折患者中,随机抽样96例患者进行疗效观察,并将抽样样本按随机数字表法分成对照组和观察组,每组48例。其中对照组患者采用常规的入路开放手术进行治疗,观察组的患者则采用经椎旁肌间隙入路伤椎植骨内固定方法进行治疗。结果：观察组患者手术的耐受性都很好,70～110 min,手术的平均出血量为（150.8±18.4）mL,且所有患者在手术中没有出现并发症。手术完成之后,本组患者在24～48 h之内就可以下床进行活动,在术后两年内接受回访的患者恢复情况良好,内固定去除之后有5例出现骨折部位二次塌陷的问题。对照组在手术中有3例无法耐受手术,手术时间为80～130 min,平均出血量（235.4±25.4）mL,有4例患者在手术后出现并发症。手术完成之后患者一般在72 h左右能下床进行活动。术后两年内接受回访发现,本组患者在内固定去除之后,有13例出现骨折部位的二次塌陷。经过对比,观察组临床治疗效果要明显优于对照组。结论：采用经椎旁肌间隙入路伤椎植骨内固定治疗对胸腰椎爆裂性骨折患者具有较好的临床治疗效果,和常规的入路开放手术相比,具有损伤小、近期效果好的优势。

Clinical Observation of 96 Cases of Road by Paraspinal Muscle Injury Vertebral Bone graft and Internal Fixation of Thoracolumbar Burst Fractures

Objective： To observe and analyze road by paraspinal muscle injury vertebral fixation clinical outcomes in patients with thoracolumbar burst fractures of the bone graft.Method： Since September 2008 - March 2012 in our hospital all patients with thoracolumbar burst fractures, randomly selected 96 patients underwent curative effect observation as samples. The samples were randomly divided into control group and observation group, 48 cases in each group. Among the control group they were treated by conventional open surgery approach for treatment. The observation group was treated with the paraspinal muscle approach vertebral bone graft and internal fixation.Result： After treatment, observation group tolerance was very good, operation time was 70-110 minutes. The average blood loss was （150.8±18.4） mL, and all the patients had no complications during surgery. After the surgery completed, patients could get out of bed activities within 24-48 hours. Visited patients in two years found recovering well after surgery. After removal of internal fixation of the fracture site, 5 cases had appeared secondary collapse. 3 cases in the surgery couldn’t tolerate surgery in the control group. Operation time was 80-130 minutes, average blood loss was （235.4±25.4）mL, and 4 patients had complications after surgery. After operation patients generally got out of bed activities within 72 hours. Visited within two years after the removal of this group, including fixed, there were 13 cases of fracture site appeared secondary collapse. By comparison, effect of the observation group was significantly better than that of the control group.Conclusion： Adopted by the paraspinal muscle injury road vertebral bone graft and internal fixation of thoracolumbar burst fracture patients have better clinical outcomes, compared with conventional open surgery approach, more less damage, more good recent effect.