转化医学杂志2026，Vol.15Issue(10)：1666-1670,5.DOI:10.3639/j.issn.2095-3097.2026.10.006
经椎旁肌间隙入路使用钉棒系统内固定联合椎弓根植骨治疗无神经损伤胸腰段椎体骨折临床疗效及安全性分析
Clinical Efficacy and Safety Analysis of Screw-Rod System Internal Fixation Combined with Pedicle Bone Grafting via Paravertebral Space Approach in the Treatment of Thoracolumbar Vertebral Fractures without Nerve Injury
摘要
Abstract
Objective To analyze the clinical efficacy and safety of screw-rod system internal fixation combined with pedicle bone grafting via paravertebral space approach in the treatment of thoracolumbar vertebral fractures without nerve injury.Methods A total of 156 patients with thoracolumbar vertebral fractures without nerve injury admitted to the 910th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force from October 2022 to January 2025 were selected and divided into paravertebral space approach group(n=78)and percutaneous group(n=78)using a random number table method.Both groups underwent screw-rod system internal fixation combined with pedicle bone grafting,with the percutaneous group receiving percutaneous minimally invasive approach and the paravertebral space approach group receiving paravertebral space approach.The surgery-related indexes,imaging indexes[anterior vertebral body height ratio(AVBH),Cobb angle,spinal canal encroachment rate(SCER)],pain and functional impairment severity[visual analogue scale(VAS),Oswestry Disability Index(ODI)],and complication rates were compared between the two groups.Results Compared with the percutaneous group,the paravertebral space approach group had shorter surgical time and hospital stay(P<0.05),and fewer intraoperative fluoroscopy times(P<0.05).There were no statistically significant differences between the two groups in intraoperative blood loss,postoperative drainage volume,or postoperative ambulation time(P>0.05).Compared with preoperative values within the same group,both groups showed increased AVBH(P<0.05)and decreased Cobb angle and SCER(P<0.05)at 1,6,and 12 months postoperatively;the AVBH was higher and the Cobb angle and SCER were lower in the paravertebral space approach group than in the percutaneous group at all three time points(P<0.05).Compared with preoperative values,both groups had decreased VAS and ODI scores at 1,6,and 12 months postoperatively(P<0.05).At 1 month postoperatively,the VAS score in the percutaneous group was lower than that in the paravertebral space approach group(P<0.05);at 6 and 12 months postoperatively,the VAS and ODI scores in the paravertebral space approach group were lower than those in the percutaneous group(P<0.05).The overall complication rate in the paravertebral space approach group[2.56％(2/78)]was lower than that in the percutaneous group[12.82％(10/78)](P<0.05).Conclusion For thoracolumbar vertebral fractures without nerve injury,screw-rod system internal fixation combined with pedicle bone grafting via the paravertebral space approach is superior to the percutaneous approach in terms of vertebral height recovery and maintenance,kyphosis correction,long-term functional recovery,and safety,while the percutaneous approach has more advantages in early pain control.关键词
无神经损伤胸腰段椎体骨折/椎旁肌间隙入路/经皮微创入路/钉棒系统内固定/椎弓根/植骨/并发症Key words
thoracolumbar vertebral fractures without nerve injury/paravertebral space approach/percutaneous minimally invasive approach/screw-rod system internal fixation/pedicle/bone grafting/complications引用本文复制引用
蔡惠民,陈昆,林龙泉,陈守勃,徐谦..经椎旁肌间隙入路使用钉棒系统内固定联合椎弓根植骨治疗无神经损伤胸腰段椎体骨折临床疗效及安全性分析[J].转化医学杂志,2026,15(10):1666-1670,5.基金项目
福建省自然科学基金项目(2021J01261) （2021J01261）
