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1、·298·JournalofPracticalOrthopaedicsVol.17,No.4,Apr.2011文章编号:1008-5572(2011)04-0298-03经椎旁肌间隙入路治疗胸腰段椎体骨折周景和,徐良丰,邹平,徐华梓(温州医学院附属第二医院脊柱外科,浙江温州325000)摘要:目的探讨经椎旁肌间隙入路复位内固定术治疗胸腰段椎体骨折的治疗效果。方法2006年6月至2009年12月,采用后路切开复位内固定术治疗无神经损伤表现的胸腰段椎体骨折患者45例。随机采用经椎旁肌间隙入路23例,男15例,女8例;年龄18～65岁,平均40.4岁。传统后正中入路22例,男
2、16例,女6例;年龄21～59岁,平均41.5岁。比较两组患者围手术期参数及影像学指标。结果通过围手术期疗效观察,发现经椎旁肌间隙入路手术与传统后正中手术相比较在手术时间上差异不大,在伤椎Cobb角的矫正度上差异亦无统计学意义,但在出血量、术后引流量、卧床时间、住院天数以及术后疼痛视觉模拟评分(visualanaloguescale,VAS)等方面都具有显著的优势,差异有统计学意义(P<0.05)。所有患者均获得随访,平均随访时间20个月(12～26个月),所有随访患者的骨折椎体均获得愈合,无一例发生骨折复位丢失及内固定物的松动、断裂,两组间远期疗效无差异。结论经椎旁肌
3、间隙入路内固定治疗胸腰段椎体骨折具有创伤小、出血少、术者操作简单、术后患者恢复快等优点。关键词:脊柱骨折;微创性;治疗中图分类号:R683.2文献标识码:BSurgicalTreatmentofThoracolumbarFracturesthroughtheApproachbetweenPara-vertebralMuscleZHOUJing-he,XULiang-feng,ZOUping,etal(DepartmentofOrthopaedics,theSecondAffiliatedHospitaltoWenzhouMedicalCollege,Wenzhou325
4、000,China)Abstract:ObjectiveToinvestigatetheresultsoftheoperativetreatmentofthoracolumbarfracturesthroughtheapproachbetweenthepara-vertebralmuscle.MethodsFromJune2006toDecember2009,atotalof45patients,whosufferedfromthoracolumbarvertebralfractureswithneurologicalintact,underwentposterioro
5、penreductionandin-ternalfixation.Randomly,23patientsadoptedtheaboveapproach,including15malesand8femaleswiththemeanageof40.4years;22patientsadoptedtraditionalapproach,l6malesand6femaleswiththemeanageof41.5years.Tocomparethetwogroups′parameterofperioperativeperiodandintervertebralindicator
6、s.ResultsThroughcompari-sonbetweentheabovetwogroupsearlierpost-operatively,theresultsconfirmedthattheapproachhadobviousadvan-tageovertraditionalmethodinbloodloss,drainage,durationofrecumbence,lengthofstayandvisualanaloguescale(VAS),andthedifferencewasofstatisticalsignificance(P<0.05),alt
7、houghthetime-consumingandthethecorrec-tionofCobb′sanglewasalmostthesamebetweenthetwoapproaches.Allpatientswereavailableandallgotboneu-niononfinalfollow-upwithdurationfrom12to26months(mean,20months).Neitherreductionlossnorlooseningorbreakageofthefixatorhadoccurredintwogrou
