椎旁肌间隙入路结合伤椎椎弓根钉固定治疗胸腰段椎体骨折

目的评估椎旁肌间隙入路结合伤椎椎弓根钉固定治疗胸腰段椎体骨折的临床疗效。方法将40例胸腰段椎体骨折患者分为经椎旁肌间隙入路结合伤椎椎弓根螺钉内固定组(A组,20例)和传统后正中入路跨伤椎椎弓根螺钉内固定组(B组,20例),比较两组的手术时间、术中及术后出血量、VAS评分、椎体高度矫正率、复位丢失率等项指标。结果手术时间、术后即刻椎体高度矫正率两组比较差异无统计学意义(P0.05);两组术后VAS评分与术前比较差异均有统计学意义(P0.05);出血量、术后VAS评分、术后3个月椎体高度矫正率、复位丢失率A组均优于B组,差异有统计学意义(P0.05)。结论椎旁肌间隙入路结合伤椎椎弓根钉固定治疗胸腰段椎体骨折具有术者操作简单、创伤小、出血少、疗效好等优点。

Surgical treatment of thoracolumbar vertebral fracture through paraspinal approach using ;pedicle screw at the fracture level

Objective To evaluate the clinical efficacy of surgical treatment of thoracolumbar vertebral fracture via paraspinal approach using pedicle screw at the fracture level .Methods A total of 40 patients suffering from thoraco-lumbar fractures without nerve injury underwent surgical treatment .Twenty cases were treated by pedicle screw fixa-tion via paraspinal approach using pedicle screw at the fracture level ( group A) and 20 cases were treated via conven-tional approach using pedicle screw cross the fracture level (group B).The following data were compared:operation time, bleeding, VAS, correct rate of vertebral height and loss rate of reduction .Results There was no significant difference in operation time and postoperative correct rate of vertebral height between two groups (P>0.05).There was significant difference in VAS between preoperation and postoperation in both two groups ( P<0.05 ) and signifi-cant difference in bleeding , VAS,correct rate of vertebral height 3 months after operation and loss rate of reduction ( P<0.05), and group A was better than group B .Conclusions Treatment through the paraspinal approach using ped-icle screw at the fracture level has the advantages of simple operation technology , less invasive and bleeding , which can achieve good effect .