CAJ | 학술논문

目的：伤椎置钉复位脊柱骨折是近年来逐渐广泛应用的外科技术。胸腰段骨折微创手术的目的是减少创伤、融合固定节段以重建脊柱的稳定性。文中探讨采用椎旁肌间隙入路结合伤椎置钉技术治疗胸腰段骨折的近期临床疗效。方法采用该手术方式治疗胸腰段骨折患者24例，选择椎旁肌间隙入路，固定伤椎及邻近节段，通过术中操作矫形重建脊柱稳定性、矫正后凸畸形。应用视觉模拟评分法（ visual analogue scale ， VAS）及健康调查简表（ the MOS item short-form health sutvey， SF-36）评估患者疼痛及生活质量改善的情况，通过影像学测量评估伤椎的高度丢失及脊柱后凸畸形的矫正情况。结果所有患者的随访时间均＞1年，患者术前和术后1年随访时VAS评分分别为（7．65±0．13）、（1．54±0．07）分，SF-36量表评分分别为（90．21±2．02）、（117．21±1．02）分，差异有统计学意义（P＜0．05），表明手术可有效改善疼痛、提高生活质量。影像学评估提示患者的脊柱伤椎高度丢失和后凸畸形得到较好的矫正。结论采用椎旁肌间隙入路结合伤椎置钉技术可有效矫正伤椎高度丢失和脊柱后凸畸形，手术损伤小，融合固定节段少，具有良好的临床疗效。
목적：상추치정복위척주골절시근년래축점엄범응용적외과기술。흉요단골절미창수술적목적시감소창상、융합고정절단이중건척주적은정성。문중탐토채용추방기간극입로결합상추치정기술치료흉요단골절적근기림상료효。방법채용해수술방식치료흉요단골절환자24례，선택추방기간극입로，고정상추급린근절단，통과술중조작교형중건척주은정성、교정후철기형。응용시각모의평분법（ visual analogue scale ， VAS）급건강조사간표（ the MOS item short-form health sutvey， SF-36）평고환자동통급생활질량개선적정황，통과영상학측량평고상추적고도주실급척주후철기형적교정정황。결과소유환자적수방시간균＞1년，환자술전화술후1년수방시VAS평분분별위（7．65±0．13）、（1．54±0．07）분，SF-36량표평분분별위（90．21±2．02）、（117．21±1．02）분，차이유통계학의의（P＜0．05），표명수술가유효개선동통、제고생활질량。영상학평고제시환자적척주상추고도주실화후철기형득도교호적교정。결론채용추방기간극입로결합상추치정기술가유효교정상추고도주실화척주후철기형，수술손상소，융합고정절단소，구유량호적림상료효。
Objective Pedode foxatoon at the level of fracture vetebral technology is widely used in rebuilding spnal fracture recently.The purpose of minimally invasive surgery for thoracolumbar fractures is to reduce the injury , fix segments, and rebuild the stability of the spine .This study aimed to investigate the short-term clinical effect of pedicle fixation at the fractured vertebra via the pa-ravertebral intermuscular approach for the treatment of thoracolumbar fractures . Methods We treated 24 cases of thoracolumbar fracture by pedicle fixation at the fractured vertebra via the paravertebral intermuscular approach , rebuilt spinal stability , and corrected kyphotic deformity .We evaluated the improvement of pain symptoms and life quality using The Visual Analogue Scale ( VAS) and The MOS 36-Item Short-Form Health Survey (SF-36), and assessed the corrected status of vertebral height loss and kyphotic deformity by radiographic measurement .All the patients were followed up for over 12 months. Results The VAS score of the patients was signifi-cantly higher while the SF-36 score remarkably lower before surgery than the scores in 12 months which were ([7.65 ±0.13] -[1.54 ±0.07], P<0.05) and ([90.21 ±2.02]-[117.21 ±1.02], P<0.05).Imaging evaluation showed desirable correction of the reduced height of the injured vertebrae and kyphotic deformity . Conclusion Pedicle fixation at the fractured vertebra via the pa-ravertebral intermuscular approach , with its advantages of minimal invasiveness and fewer segments of fixation , can effectively correct vertebral height reduction and kyphotic deformity .