CAJ | 학술논문

目的：探讨微创肌间隙入路结合伤椎短节段固定技术治疗胸腰椎爆裂骨折的临床疗效。方法对32例胸腰椎爆裂骨折患者采用微创肌间隙入路加伤椎6钉固定技术治疗，所有患者均未植骨。对术前、术后、末次随访时的伤椎前缘高度、后凸 Cobb 角进行测量，进行疼痛 VAS 评分，测量末次随访时伤椎前后滑移距离。结果患者均获得随访，时间12~25(18．7±5．7)个月。伤椎前缘高度、后凸 Cobb 角均有显著性改善(P <0．05)，末次随访时动力位 X 线片上伤椎椎体前后相对滑移距离为1． 2~2．7(2．1±0．5)mm。 VAS 评分：术后(2．3±0．6)分，末次随访时(1．4±0．7)分，与术前(6．7 ± 0．5)分比较差异均有统计学意义(P <0．05)。结论微创经肌间隙入路结合伤椎固定技术治疗胸腰椎爆裂骨折创伤小，出血少，复位好，稳定性好，术后并发症少，是治疗胸腰椎骨折的有效方法。
목적：탐토미창기간극입로결합상추단절단고정기술치료흉요추폭렬골절적림상료효。방법대32례흉요추폭렬골절환자채용미창기간극입로가상추6정고정기술치료，소유환자균미식골。대술전、술후、말차수방시적상추전연고도、후철 Cobb 각진행측량，진행동통 VAS 평분，측량말차수방시상추전후활이거리。결과환자균획득수방，시간12~25(18．7±5．7)개월。상추전연고도、후철 Cobb 각균유현저성개선(P <0．05)，말차수방시동력위 X 선편상상추추체전후상대활이거리위1． 2~2．7(2．1±0．5)mm。 VAS 평분：술후(2．3±0．6)분，말차수방시(1．4±0．7)분，여술전(6．7 ± 0．5)분비교차이균유통계학의의(P <0．05)。결론미창경기간극입로결합상추고정기술치료흉요추폭렬골절창상소，출혈소，복위호，은정성호，술후병발증소，시치료흉요추골절적유효방법。
Objective To evaluate the clinical efficacy of minimally invasive treatment of thoracolumbar burst frac-ture through para-vertebral muscles using pedicle screw at the fracture level. Methods A retrospective clinical study was done in 32 patients with thoracolumbar fracture who were treated with the minimally invasive pedicle screw fixa-tion. The index of image and pain and disability index were evaluated after operation. Results The patients were followed up for 12 ~ 25(18. 7 ± 5. 7)months. Significant difference was noted in terms of the percentage of vertebral compression and Cobb angle of the injured vertebral segment(P < 0. 05). The sliding distance of the injured vertebral body and its adjacent vertebral body were 1. 2 ~ 2. 7(2. 1 ± 0. 5)mm in the dynamic lateral X-ray at later follow-up stage. The VAS of back pain improved from (6. 7 ± 0. 5)to postoperative (2. 3 ± 0. 6), and(1. 4 ± 0. 7)at last fol-low-up, which showed significant differences compared with preoperation counterpart(P < 0. 05). All patients were re-covered normal work. Conclusions Using pedicle screw fixation at the fracture level through para-vertebral muscles is an excellent therapeutic choice for patients with thoracolumbar burst fracture. It shows the characteristics including easy performance, less complications and blood loss. Additionally, the surgery has good reduction and stable, relia-ble fixation after operation.