CAJ | 학술논문

目的：比较传统后正中入路与经椎旁肌间隙手术入路在胸腰椎爆裂骨折中的应用效果。方法选择2012年2月~2013年2月本院诊治的80例胸腰椎爆裂骨折为研究对象,随机分为A组与B组各40例,A组采用传统后正中入路治疗,B组采用经椎旁肌间隙入路治疗。比较两组手术前后的椎体前缘高度、伤椎Cobb角、腰背痛Denis分级及手术效果。结果两组患者术后1周及术后6个月伤椎前缘高度、Cobb角均较治疗前显著改善(P<0.05),但两组间比较差异无统计学意义(P>0.05)；B组术中出血量、术后引流量少于A组,引流管留置时间及下床活动时间短于A组,差异有统计学意义(P<0.05)；B组患者术后1周及3个月腰背痛Denis分级1级的患者比例高于A组,差异有统计学意义(P<0.05)。结论经椎旁肌间隙入路与传统后正中入路治疗胸腰椎爆裂骨折均可达到理想的整复效果,但前者对机体损伤小、术后恢复快且患者疼痛轻。
목적：비교전통후정중입로여경추방기간극수술입로재흉요추폭렬골절중적응용효과。방법선택2012년2월~2013년2월본원진치적80례흉요추폭렬골절위연구대상,수궤분위A조여B조각40례,A조채용전통후정중입로치료,B조채용경추방기간극입로치료。비교량조수술전후적추체전연고도、상추Cobb각、요배통Denis분급급수술효과。결과량조환자술후1주급술후6개월상추전연고도、Cobb각균교치료전현저개선(P<0.05),단량조간비교차이무통계학의의(P>0.05)；B조술중출혈량、술후인류량소우A조,인류관류치시간급하상활동시간단우A조,차이유통계학의의(P<0.05)；B조환자술후1주급3개월요배통Denis분급1급적환자비례고우A조,차이유통계학의의(P<0.05)。결론경추방기간극입로여전통후정중입로치료흉요추폭렬골절균가체도이상적정복효과,단전자대궤체손상소、술후회복쾌차환자동통경。
Objective To compare the effect of postmiddle approach and posterior paraspinal muscle approach in the treatment of thoracolumbar burst fractures. Methods 80 cases of patients with thoracolumbar burst fracture treated in our hospital from February 2012 to February 2013 were selected and randomly divided into group A and group B.Post-middle approach was given to group A,posterior paraspinal muscle approach was taken to group B.The anterior height of vertebral body,Cobb angle of injured cord,Denis classification and surgery effect were compared between two groups. Results The anterior height of vertebral body and Cobb angle of injured cord after 1 week and 6 months treatment were both improved compared with before treatment in the two groups (P<0.05),but there were no significant differences be-tween two groups after treatment (P>0.05).The amount of bleeding,postoperative drainage of group B were less than those of group A,drainage time and bed time were shorter than those of group A,the differences were significant (P<0.05).1 grade of Denis classification after 1 week and 3 months operation in group B were higher than those of group A, the differences were significant (P<0.05). Conclusion Posterior paraspinal muscle approach and postmiddle approach for treatment of thoracolumbar burst fractures have ideal reduction effect,while the former has the advantages of less in-jure,faster recovery and less pain.