本文選題：胸椎　切入點(diǎn)：腰椎　出處：《中國組織工程研究》2017年19期

【摘要】：背景:胸腰椎骨折是脊柱最常見的骨折類型,傳統(tǒng)的后正中入路對(duì)椎旁肌的廣泛剝離與牽拉,椎旁肌缺血和失神經(jīng)支配,導(dǎo)致術(shù)后腰背肌萎縮,并產(chǎn)生頑固性的腰背痛。而微創(chuàng)手術(shù)治療越來越被廣大的骨科醫(yī)生所接受。目的:探討經(jīng)椎旁肌間隙椎弓根螺釘內(nèi)固定結(jié)合可注射硫酸鈣骨水泥治療單一椎體胸腰椎骨折的臨床療效。方法:回顧性分析獲得完整隨訪資料的52例單一椎體胸腰椎骨折不伴有神經(jīng)損傷患者,根據(jù)手術(shù)入路分為2組。觀察組28例,采用后路經(jīng)椎旁肌間隙入路短節(jié)段椎弓根螺釘固定結(jié)合傷椎硫酸鈣植入;對(duì)照組24例,采用傳統(tǒng)后正中入路短節(jié)段椎弓根螺釘固定結(jié)合傷椎硫酸鈣植入。比較2組患者的手術(shù)時(shí)間、手術(shù)出血量、住院時(shí)間:觀察2組患者術(shù)前及術(shù)后1周、3個(gè)月時(shí)腰背部疼痛情況;觀察2組患者術(shù)前、術(shù)后下地前和末次隨訪時(shí)X射線片上傷椎前緣高度百分比;記錄2組患者手術(shù)并發(fā)癥及內(nèi)固定松動(dòng)、斷裂情況。結(jié)果與結(jié)論:(1)52例患者均獲得隨訪,隨訪時(shí)間16-24個(gè)月;(2)觀察組手術(shù)時(shí)間、手術(shù)出血量及住院時(shí)間均少于對(duì)照組,差異均有顯著性意義(P0.05);(3)2組術(shù)后不同時(shí)點(diǎn)目測類比評(píng)分均低于術(shù)前(P0.05);2組術(shù)后不同時(shí)間點(diǎn)目測類比評(píng)分比較,差異均有顯著性意義(P0.05)。(4)2組患者術(shù)后下地前及末次隨訪時(shí)傷椎前緣高度百分比均較術(shù)前明顯改善,差異均有顯著性意義(P0.05);2組間不同時(shí)點(diǎn)傷椎前緣高度比值比較,差異均無顯著性意義(P0.05);(5)結(jié)果提示,在嚴(yán)格掌握手術(shù)適應(yīng)證的前提下,經(jīng)椎旁肌間隙入路椎弓根螺釘固定結(jié)合硫酸鈣治療單一椎體胸腰椎骨折安全可靠,可即刻恢復(fù)傷椎前緣高度,減輕疼痛,遠(yuǎn)期療效滿意。和傳統(tǒng)后正中入路手術(shù)相比,手術(shù)時(shí)間更短,術(shù)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鍏，

本文編號(hào)：1678226