椎旁肌间隙入路内固定治疗胸腰段椎体骨折

目的探讨经多裂肌及最长肌肌间隙入路（以下简称肌间隙入路）和传统后正中入路钉棒系统内固定治疗胸腰段椎体骨折临床疗效比较。方法回顾2006年8月至2010年3月经后路钉棒系统撑开复位内固定治疗56例无神经症状胸腰段椎体骨折患者，其中采用肌间隙入路30例，男17例，女13例，年龄30～60岁，平均40．7岁；传统椎旁肌剥离人路26例，男19例，女7例，年龄24～54岁，平均3Q．2岁。记录两组患者手术时间和出血量，测定两组患者术前术后胸腰段后凸畸形Cobb角，对相关临床数据进行统计学分析。结果所有患者均获得随访，术后随访时间18～24个月，平均19个月，肌间隙入路手术时间短，出血少，两组患者术前术后Cobb角差异有统计学意义，临床疗效相同。结论肌间隙入路钉棒系统内固定治疗无神经症状的胸腰段椎体骨折具有置钉方便、手术时间短，创伤小、出血少、并发症少、恢复快等优点，临床疗效满意。

Paraspinal Muscle Approach in the Treatment of Thoracic and Lumbar Spine Fractures

Objective To evaluate the clinical effect of paraspinal muscle approach and traditional posterior midline approach in the treatment of thoracic and lumbar spine fractures with screw-stick systems fixation and compare this approach with traditional Posterior midline approach. Methods From August 2006 to March 2010,a total of 52 cases of thoracic and lumbar spine fractures neurological symptoms with no were reviewed. All cases were treated through distraction reduction with screw-stick systems internal fixation. 30 cases were treated with paraspinal muscle approach,including 17 males and 13 females,with an average age of 40.7 years （range , 30- 60 years）. 26 cases were treated with traditional posterior midline approach,including 19 males and 7 females,with an average age of 30. 2 years （range, 24~ 54 years）. The operation time ,the amount of bleeding,pre-post operative rhachiokyphosis Cobb an- gle were recorded and analysized. Results All cases were followed up for in average of 19 months （range 18- 24 months）. Paraspinal muscle approach need less operation time with less bleeding. Significnat differences was found in terms of pre-post operative kyphosis Cobb angle of two groups. Two approach had similar clinical effect. Conclusion Paraspinal muscle approach for thoracic and lumbar spine fractures with screw-stick systems internal fixation is an ef- fective treatment ,with conveniention of screw placement,less trauma,less bleeding,less complication. Its clinical ef- fect was satisfactory.