经椎旁肌间隙入路椎弓根螺钉固定结合硫酸钙治疗单一椎体胸腰椎骨折

发布时间：2018-03-28 22:00

  本文选题：胸椎　切入点：腰椎　出处：《中国组织工程研究》2017年19期

【摘要】：背景:胸腰椎骨折是脊柱最常见的骨折类型,传统的后正中入路对椎旁肌的广泛剥离与牵拉,椎旁肌缺血和失神经支配,导致术后腰背肌萎缩,并产生顽固性的腰背痛。而微创手术治疗越来越被广大的骨科医生所接受。目的:探讨经椎旁肌间隙椎弓根螺钉内固定结合可注射硫酸钙骨水泥治疗单一椎体胸腰椎骨折的临床疗效。方法:回顾性分析获得完整随访资料的52例单一椎体胸腰椎骨折不伴有神经损伤患者,根据手术入路分为2组。观察组28例,采用后路经椎旁肌间隙入路短节段椎弓根螺钉固定结合伤椎硫酸钙植入;对照组24例,采用传统后正中入路短节段椎弓根螺钉固定结合伤椎硫酸钙植入。比较2组患者的手术时间、手术出血量、住院时间:观察2组患者术前及术后1周、3个月时腰背部疼痛情况;观察2组患者术前、术后下地前和末次随访时X射线片上伤椎前缘高度百分比;记录2组患者手术并发症及内固定松动、断裂情况。结果与结论:(1)52例患者均获得随访,随访时间16-24个月;(2)观察组手术时间、手术出血量及住院时间均少于对照组,差异均有显著性意义(P0.05);(3)2组术后不同时点目测类比评分均低于术前(P0.05);2组术后不同时间点目测类比评分比较,差异均有显著性意义(P0.05)。(4)2组患者术后下地前及末次随访时伤椎前缘高度百分比均较术前明显改善,差异均有显著性意义(P0.05);2组间不同时点伤椎前缘高度比值比较,差异均无显著性意义(P0.05);(5)结果提示,在严格掌握手术适应证的前提下,经椎旁肌间隙入路椎弓根螺钉固定结合硫酸钙治疗单一椎体胸腰椎骨折安全可靠,可即刻恢复伤椎前缘高度,减轻疼痛,远期疗效满意。和传统后正中入路手术相比,手术时间更短,术中出血量更少。
[Abstract]:Background: thoracic and lumbar fractures are the most common type of spinal fractures, the traditional posterior median approach widely stripping of the paraspinal muscles and stretch, paraspinal muscle ischemia and denervation, leading to postoperative low back muscle atrophy, and intractable back pain. But more and more the minimally invasive surgical treatment of Department of orthopedics the doctor accepted. Objective: To explore the paraspinal muscle gap of pedicle screw fixation combined with injectable calcium sulfate bone cement for the treatment of the clinical curative effect of single vertebral thoracolumbar fractures. Methods: a retrospective analysis of patients with nerve injury in 52 cases of single vertebral thoracolumbar fractures with complete follow-up, according to the surgical approach were divided into 2 groups the observation group 28 cases, the posterior paraspinal muscle approach for segmental pedicle screw fixation combined with vertebral implantation of calcium sulfate; the control group of 24 cases, using the traditional posterior approach short segment pedicle screw fixation combined with vertebral sulfate 閽欐�嶅叄�

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