中国组织工程研究Issue(40)：6451-6458,8.DOI:10.3969/j.issn.2095-4344.2014.40.010
椎弓根螺钉椎旁肌间隙与后正中入路内固定修复胸腰椎骨折：稳定性比较
Pedicle screw paraspinal muscle approach versus posterior median approach fixation for thoracolumbar fractures:comparison of the stability
张兆川 1马超 1吴德慧 1吴继彬 1戴维享 1王兆红 1韩猛 1冯杰 1刘光普1
作者信息
- 1. 徐州市中心医院骨科，江苏省徐州市 221009
- 折叠
摘要
Abstract
BACKGROUND:Spinal posterior surgery is the most common treatment method for thoracolumbar fracture. During exposure of conventional posterior surgery, a wide-range stripping and pul ing of paraspinal muscles easily induced failure syndrome of lumbar surgery. <br> OBJECTIVE:To compare the reset conditions and stability of thoracolumbar fractures after treatment with pedicle screw paraspinal muscle approach and conventional posterior median approach fixation. <br> METHODA total of 62 patients with thoracolumbar fractures without nerve injury were retrospectively analyzed. 22 patients were treated with paraspinal muscle approach and general spine system. 21 patients were treated with conventional median approach and general spine system. 19 patients were treated with conventional median approach and AF internal fixation system. The therapeutic effects of the three kinds of fixation methods were compared by comparing clinical indexes in patients of the three groups, including operation time, intraoperative blood loss, postoperative drainage, dead space volume, scores of the Visual Analogue Scale of back pain, wound complications, height of injured vertebrae and the Cobb angle. <br> RESULTS AND CONCLUSION:Operation time, intraoperative blood loss, postoperative drainage and dead space volume were better in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group (P<0.05). No significant difference in height of injured vertebrae and the Cobb angle was detectable among the three groups at 3 days after fixation (P>0.05). No significant difference in scores of the Visual Analogue Scale of back pain was visible among the three groups at 1 week after fixation (P>0.05). The scores of the Visual Analogue Scale of back pain were apparently lower in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group at 3 and 6 months after fixation. No incision infection was observed in patients of the three groups. These results suggested that compared with conventional posterior median approach, paraspinal muscle approach has some advantages, such as smal trauma, less bleeding, postoperative rapid recovery, and high degree of satisfaction. The effects of general spine system and AF internal fixation system in the repair of thoracolumbar fractures on internal fixation are similar, but general spine system has some advantages such as simple to be operated, save time, less bleeding, stable fixation and good reduction. General spine system combined with paraspinal muscle approach is a good method to repair thoracolumbar spine fracture.关键词
植入物/脊柱植入物/椎旁肌间隙入路/胸腰椎/骨折/传统正中入路,GSS内固定系统/AF内固定系统Key words
thoracic vertebrae/lumbar vertebrae/fractures, bone/internal fixators/fol ow-up studies分类
医药卫生引用本文复制引用
张兆川,马超,吴德慧,吴继彬,戴维享,王兆红,韩猛,冯杰,刘光普..椎弓根螺钉椎旁肌间隙与后正中入路内固定修复胸腰椎骨折：稳定性比较[J].中国组织工程研究,2014,(40):6451-6458,8.
