经肌间隙入路与传统入路治疗胸腰椎骨折的疗效比较

目的对比肌间隙入路与传统后正中入路椎弓根螺钉固定治疗无神经症状型胸腰椎骨折的临床疗效。方法2009年10月至2011年11月收治的无神经症状、无需椎管减压的胸腰椎骨折患者120例,随机分为两组:肌间隙入路组及传统后正中入路组,行椎弓根螺钉内固定,分析手术时间、出血量、术后下地时间、Cobb角矫正度、术前、术后1周及术后1个月疼痛视觉模拟量表评分和术后1年随访腰背痛日本骨科协会(Japanese orthopaedic association,JOA)评分。结果椎旁肌间隙入路在手术时间、出血量、术后下地时间、术后1周及术后1个月疼痛视觉模拟量表评分、术后1年腰背痛JOA评分上均明显优于常规入路(P0.05),Cobb角矫正度两组对比差异无统计学意义。结论经多裂肌和最长肌间隙入路保留了多裂肌的完整性,能显著减少手术创伤及术后腰背痛的发生,是一种实用的手术方法。

Clinical Outcome of Pedicale Screw Fixation through Tow Different Approach in Treatment of Thoracic and Lumbar Fracture

Objective To evaluate the clinical outcomes of thoracolumbar fractures treatment through pedicle screw fixtion with intrasacrospinal muscular approach and conventional approach. Methods From October 2009 to November 2011, a total of 120 cases of non-neurological symptoms patients with thoracic and lumbar spine fractures were included in the study. The patients were divided into two groups ： intrasacrospinal muscular approach group and conventional approach group. We analyzed operative time,blood loss, duration of recumbence, the correction of Cobb＇s angle, preoperative and postoperative VAS score and the low back pain JOA score after one year. Results Intrasacrospinal Muscular Approach group in operative time, blood loss,duration of recumbence,postoperative VAS score and the low back pain JOA score were significantly better than the con- ventional approach type. The correction of Cobb＇s angle between the two groups were not statistically significant. Conclusion Treatment of pedicle screw fixtion for the thoracolumbar fracture with intrasacrospinal muscular approach is a practical compre- hensive method.