中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
15期
32-33
,共2页
程文丹%李品%江淮%邵松%刘兴国%吕建军
程文丹%李品%江淮%邵鬆%劉興國%呂建軍
정문단%리품%강회%소송%류흥국%려건군
胸腰骨折%椎旁肌间隙入路%微创
胸腰骨摺%椎徬肌間隙入路%微創
흉요골절%추방기간극입로%미창
Thoracolumbar fracture%Paraspinal approach%Minimally invasive
目的：探讨后路经椎旁肌间隙椎弓根螺钉棒系统治疗无神经症状胸腰椎骨折的临床疗效。方法对27例无神经症状的胸腰椎骨折患者,采用后路经肌间隙入路椎弓根螺钉棒系统撑开复位内固定治疗,观察手术时间、术中出血情况及术前、术后椎体前缘高度、后凸Cobb角及腰椎疼痛恢复情况。结果手术时间55~110 min,平均75.8 min。术中出血量100~200 ml,平均120 ml。术后随访12~16个月,平均13.5个月。末次随访椎体前缘高度恢复至(90.2±4.6)%,后凸Cobb角矫正至(5.7±1.6)°, VAS评分(1.9±0.8)分,较术前差异有统计学意义(P<0.01)。所有病例未发现神经损伤、内固定失效及腰背部疼痛及腰椎失能。结论后路经椎旁肌间隙椎弓根螺钉棒系统治疗无神经症状胸腰椎骨折可有效保留脊柱后方肌肉复合体结构,具有创伤小、出血少和降低术后腰背痛和腰椎失能发生率的优点。
目的：探討後路經椎徬肌間隙椎弓根螺釘棒繫統治療無神經癥狀胸腰椎骨摺的臨床療效。方法對27例無神經癥狀的胸腰椎骨摺患者,採用後路經肌間隙入路椎弓根螺釘棒繫統撐開複位內固定治療,觀察手術時間、術中齣血情況及術前、術後椎體前緣高度、後凸Cobb角及腰椎疼痛恢複情況。結果手術時間55~110 min,平均75.8 min。術中齣血量100~200 ml,平均120 ml。術後隨訪12~16箇月,平均13.5箇月。末次隨訪椎體前緣高度恢複至(90.2±4.6)%,後凸Cobb角矯正至(5.7±1.6)°, VAS評分(1.9±0.8)分,較術前差異有統計學意義(P<0.01)。所有病例未髮現神經損傷、內固定失效及腰揹部疼痛及腰椎失能。結論後路經椎徬肌間隙椎弓根螺釘棒繫統治療無神經癥狀胸腰椎骨摺可有效保留脊柱後方肌肉複閤體結構,具有創傷小、齣血少和降低術後腰揹痛和腰椎失能髮生率的優點。
목적：탐토후로경추방기간극추궁근라정봉계통치료무신경증상흉요추골절적림상료효。방법대27례무신경증상적흉요추골절환자,채용후로경기간극입로추궁근라정봉계통탱개복위내고정치료,관찰수술시간、술중출혈정황급술전、술후추체전연고도、후철Cobb각급요추동통회복정황。결과수술시간55~110 min,평균75.8 min。술중출혈량100~200 ml,평균120 ml。술후수방12~16개월,평균13.5개월。말차수방추체전연고도회복지(90.2±4.6)%,후철Cobb각교정지(5.7±1.6)°, VAS평분(1.9±0.8)분,교술전차이유통계학의의(P<0.01)。소유병례미발현신경손상、내고정실효급요배부동통급요추실능。결론후로경추방기간극추궁근라정봉계통치료무신경증상흉요추골절가유효보류척주후방기육복합체결구,구유창상소、출혈소화강저술후요배통화요추실능발생솔적우점。
Objective To investigate the clinical effects of surgical treatment of thoracolumbar fractures with pedicle screw and rod fixation system through the paraspinal approach.Methods From September 2010 to December 2012, 27 cases of non-neurological symptoms patients with thoracolumbar fractures were treated with posterior pedicle screw and rod system by distraction reduction and internal fixation through the paraspinal approach. The operation time, blood loss, the height of the anterior border and the Cobb’s angle restoration and pain visual analog scale (VAS) score between the preoperative and postoperative were observed.Results Median operating time was 74.2 min (range 50~96 min) and median blood loss was l20 ml (range 100~200 ml). Average follow-up time was 13.5 months (range 12~16 months). At the latest follow-up, the height of the anterior border was corrected to (90.2±4.6)%, the Cobb’s angle was (5.7±1.6)°and VAS was (1.9±0.8). Compared with preoperation, the differences were significant (P<0.01). There were no instances of nerve injury, instrumentation failure and no patient had persistent postoperative chronic back pain and disability.Conclusion The treatment of thoracolumbar fractures with pedicle screw and rod fixation system through the paraspinal approach can retainthe posterior ligament complex, has the advantages of less invasive, blood loss and decreases the risks of postoperative chronic back pain and disability.
