比较经皮和传统开放及肌间隙入路治疗胸腰椎骨折的疗效

目的 比较经皮、传统开放和肌间隙入路治疗胸腰椎骨折的临床疗效.方法 分析2014年6月至2018年6月,我院收治的126例胸腰椎骨折患者,男66例,女60例.年龄25～56岁,平均(41.87±7.31)岁.根据手术入路分为经皮组、传统开放组和肌间隙组,比较三组临床相关资料.结果 经皮组出血量和住院时间明显减少(P<0...

Percutaneous,traditional open and intermuscular approaches in the treatment of thoracolumbar fracture

Objective To compare clinical effects of percutaneous,traditional open and intermuscular approaches in the treatment of thoracolumbar fracture.Methods A total of 126 cases with thoracolumbar fracture were analyzed from June 2014 to June 2018,including 66 males and 60 females with an average age of (41.87±7.31) years.All patients were divided into three groups according to the surgical approach:percutaneous approach group;traditional open surgery group;intermuscular approach group.Results Bleeding amount and hospital stay were significantly reduced in the percutaneous approach group (P < 0.05),but operation time and fluoroscopy frequency were significantly increased (P < 0.05).Bleeding amount of the traditional open surgery group was significantly more than that of the intermuscular approach group(235.95±52.27) ml vs.(92.33±24.46) ml](P < 0.05),while no significant differences in hospital stay and operation time were observed between the two groups (P >0.05).All patients were followed up for 12-18 months with an average of (15.4±2.0) months.No adverse events occurred during the follow-up.VAS and ODI scores were significantly improved after the operation (P < 0.05),while no significant differences were observed among the 3 groups 3 months after surgery (P > 0.05).VAS and ODI scores of the percutaneous approach group and intermuscular approach group were significantly superior to those of traditional open surgery group 1 week after operation (P < 0.05).ODI scores of the percutaneous approach group were significantly superior to those of intermuscular approach group (P < 0.05),while no significant differences in VAS were observed between the two groups (P > 0.05).The height of the anterior wall and the Cobb angle of kyphosis were significantly improved after surgery (P < 0.05),but no significant differences at different time nodes were noted (P > 0.05).Conclusions Percutaneous and intermuscular approach,especially percutaneous approach,is less invasive with less bleeding and quick recovery in the treatment of thoracolumbar fracture.Except for longer operation time and higher fluoroscopy frequency of percutaneous approach,no significant differences in the long-term effect are shown among the 3 methods.