经椎旁肌入路与传统入路治疗胸腰段骨折疗效比较

目的探讨脊柱经椎旁肌入路和传统入路安置椎弓根螺钉器械复位固定治疗胸腰段骨折的临床疗效。方法43例无神经损伤的胸腰段骨折,其中22例行椎旁肌入路手术,另21例行传统后正中入路手术,均行后路椎弓根螺钉复位固定,比较两种入路临床疗效。结果通过12～18个月随访(平均15个月),经椎旁肌入路与传统入路在手术时间、Cobb角矫正率、椎体塌陷矫正率、拆除内固定前JOA评分无统计学意义,经椎旁肌入路较传统入路在术中出血量、术后引流量、卧床时间及术后疼痛视觉模拟评分(VAS)等方面均有统计学意义。结论经椎旁肌入路与传统实用入路比较,进行椎弓根螺钉置入保护了椎旁肌,出血少,微创、安全、实用,术后卧床时间短,腰背部疼痛轻,疗效满意。

The comparison of paraspinal approach and traditional approach in treatment of thoracolumbar tractures

Objective To assess the surgical therapeutic result of thoracolumbar fracture by pedicle screw fixation through paraspinal approach or traditional open approach. Methods From june 2008 to November 2011,43 patients with thoracolumbar ractures without neural syndromes. 22 cases with paraspinal approach group and 21 cases with conventional posterior midline approach group by pedicle screw fixation, to assess the surgical therapeutic result of thoracolumbar frac- ture through ,paraspinal approach or traditional open approach. Results All patients were followed up with duration form 12 to 18 （mean,15 months） the differences of operation time,postoperative correction rate of Cobb angle, correction rates of collaps vertebrad and JOA scroe were＇t statistically significant,the results confirmed that the parapinal approcach had obvious advantage over traditional method in blood loss,drainage,duration of recumbence and VAS, and the difference was of statistical significance. Conclusion The paraspinal approach is an better way than the traditional approach for treating of thoracolumbar fractues,which can get less trauma, less injury of paraspinal muscle ,better safty, better available and more relief of postoperative low back pain .