CAJ | 학술논문

目的：比较胸腰椎骨折手术治疗在采用(椎旁肌间隙入路和后正中入路)两种不同入路的临床疗效。方法统计该院2010年6月—2014年6月间收治的胸腰段椎体骨折患者62例,均采用椎弓根钉棒复位内固定术治疗。将所有患者按手术入路不同,分为：Ⅰ组：椎旁肌间隙入路组；Ⅱ组：后正中入路组。对比两组的手术用时、Cobb角纠正率、术中、术后出血量,术后疼痛的VAS评分。结果两组患者手术均顺利完成,术后无并发症。两组患者在术后Cobb角纠正率上差异无统计学意义(P>0.05),Ⅰ组优于Ⅱ组。两组病例在手术时间、术中、术后出血量差异有统计学意义(P<0.05)。术后第1周时两组患者腰背部疼痛差异有统计学意义(P<0.05),Ⅰ组优于Ⅱ组；第2周两组患者腰背部疼痛性差异无统计学意义(P>0.05)。结论在胸腰椎骨折手术治疗中,对比传统的后正中入路,椎旁肌间隙入路在保证压缩椎体高度复位满意的同时,有手术时间短、创伤小、患者疼痛缓解早,术后早期康复等优点。
목적：비교흉요추골절수술치료재채용(추방기간극입로화후정중입로)량충불동입로적림상료효。방법통계해원2010년6월—2014년6월간수치적흉요단추체골절환자62례,균채용추궁근정봉복위내고정술치료。장소유환자안수술입로불동,분위：Ⅰ조：추방기간극입로조；Ⅱ조：후정중입로조。대비량조적수술용시、Cobb각규정솔、술중、술후출혈량,술후동통적VAS평분。결과량조환자수술균순리완성,술후무병발증。량조환자재술후Cobb각규정솔상차이무통계학의의(P>0.05),Ⅰ조우우Ⅱ조。량조병례재수술시간、술중、술후출혈량차이유통계학의의(P<0.05)。술후제1주시량조환자요배부동통차이유통계학의의(P<0.05),Ⅰ조우우Ⅱ조；제2주량조환자요배부동통성차이무통계학의의(P>0.05)。결론재흉요추골절수술치료중,대비전통적후정중입로,추방기간극입로재보증압축추체고도복위만의적동시,유수술시간단、창상소、환자동통완해조,술후조기강복등우점。
Objective To compare the surgical treatment of Spinal fractures through two different approaches(Posterior paramedian and the posterior midline). Methods Study 62 cases of thoracic and lumbar vertebral fracture patients in our hospital from June 2010 to June 2010, All cases adopted pedicle screw fixation treatment. All cases divided into two groups:groups Ⅰ : the Posterior paramedian approach group. Groups Ⅱ : the posterior midline approach group. Comparison of two groups in operation time, Correction rate of Cobb angle, blood loss in the operation and postoperative. Pain VAS scores. Results The operations of all cases were completed successfully. None of cases had the postoperative complications. Correction rate of Cobb angle had not statistical difference between the two groups (P > 0.05). The two groups in operation time, blood loss in the operation and postoperative was statistically difference (P < 0.05), group I was better than that of group II. It had statistically difference in the first week after operation between the two groups (P < 0.05), group I was better than that of group II. but had not statistically difference in the second week after operation (P>0.05). Conclusion The cases through the posterior paramedian appraoch in the surgical treatment of thoracolumbar fractures was not noly satisfied in restoring the fracture vertebral body`s height but also in spending shorter operation time, getting small trauma and earlier pain relief etc.