椎旁肌间隙与传统入路置钉技术在胸腰椎骨折中的效果比较研究

doi:10.13418/j.issn.1001-165x.2015.03.026

摘要/Abstract

摘要：

目的　比较椎旁肌间隙与传统入路置钉技术在胸腰椎骨折中的应用效果。方法　从2011年4月到2012年12月，收治的142例胸腰椎骨折患者以数字法随机分成观察组（71例）和对照组（71例）。对两组患者均行后侧入路置钉手术。观察组采用椎旁肌间隙入路置钉技术；对照组采用传统入路置钉技术。对比两组的手术时间，术中出血量和引流量，对比两组患者术后3d、1个月、6个月的VAS评分以及两组术后的椎体高度矫正率对比。结果　观察组手术时间为(89.52±12.15)min，出血量为(139.61±36.25)ml，引流量为(59.62±9.15)ml，显著低于对照组的(138.57±9.98) min，(413.54±29.83)ml，(373.14±11.83)ml。差异均有统计学意义（均P＜0.05）。术后3 d、1月、半年观察组VAS评分分别为（5.01±0.98）、（2.33±1.13）、（0.71±0.69），显著低于对照组的（5.55±1.15）、（3.09±1.25）和（1.74±0.85）。差异均有统计学意义（P<0.05）。观察组的矫正率达到了（96.80±2.51）%,对照组的(95.68±2.89)%。差异无统计学意义（P>0.05）。结论　椎旁肌间隙入路置钉技术在胸腰椎骨折的临床应用上具有手术时间短，安全矫正率与传统入路无差异的特点,安全性好，患者恢复情况好，值得临床的推广。

关键词: 椎旁肌间隙, 手术入路, 置钉技术, 胸腰椎骨折

Abstract:

Objective Comparative study of the efficacy of vertebral side clearance and the traditional approach nailing technology application on thoracolumbar fracture. Methods From April 2011 to December 2012, a total of 142 patients with thoracolumbar fractures underwent surgical treatment in our hospital. The patients were randomly divided into observation group (71 cases) and control group (71 cases) in a digital method. Patients in both groups of underwent pedicle screw surgery in a posterior approach patients in the observation group received the paraspinal muscle pedicle screw technology; patients in the control group received the set nail technology through the traditional approach. The surgical length, blood loss and drainage were compared in both groups during the surgery. VAS score and correction rate of postoperative vertebral height were compared 3 d, 1 month and 6 months after surgery. Results In the study group, the surgical duration was (89.52±12.15) min, blood loss was (139.61±36.25) ml, drainage was (99.62±9.15) ml, which was significantly lower than the control group (138.57±9.98) min, (413.54±29.83) ml, (373.14±11.83) ml. Differences were statistically significant ( P<0.05). In 3 d, 1 month, half a year after the surgery, VAS score in the observation group was (5.01±0.98), (2.33±1.13) and (0.71±0.69), respectively, which was significantly lower than that in the control group being (5.55±1.15), (3.09±1.25) and (1.74±0.85), respectively (P <0.05). The correct rate of the observation group was （96.80±2.51）%, and of the control group was （95.68±2.89）%. There was no statistically significant difference（P>0.05）. Conclusion Paraspinal muscle pedicle screw technology , having the advantages of being shorter in surgical duration, as reliable as the traditional approach when it comes to the correction rate, and deliver a good surgical outcome, is worthy of promotion.

Key words: Vertebral side clearance, Surgical approach, Pedicle screw placement technology, Thoracolumbar fractures

薛厚军,　潘磊,　黄必留,　刘青华,　李捷,　陈伟雄,　王诗成. 椎旁肌间隙与传统入路置钉技术在胸腰椎骨折中的效果比较研究[J]. 中国临床解剖学杂志, 2015, 33(3): 354-356.

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