本文選題：胸椎骨折 + 腰椎骨折��； 參考：《石河子大學(xué)》2015年碩士論文

【摘要】：目的:比較經(jīng)Wiltse入路與傳統(tǒng)后正中入路行切開(kāi)復(fù)位內(nèi)固定術(shù),治療胸腰椎椎體骨折的臨床療效。方法:對(duì)2012年7月~2013年7月,住院手術(shù)治療胸腰椎骨折患者62例,男40例,女22例;年齡范圍為23~78歲,平均年齡45.97歲。手術(shù)治療病例均為脊髓損傷分級(jí),Frankel分級(jí)為E級(jí)的壓縮型骨折、爆裂型骨折無(wú)神經(jīng)癥狀,且不需后路椎板減壓的患者。隨機(jī)將需要手術(shù)治療的患者分為傳統(tǒng)后正中入路組和Wiltse入路組,記錄并比較兩入路所需手術(shù)時(shí)間、術(shù)中出血量、術(shù)后引流量、住院時(shí)間、住院總費(fèi)用、術(shù)前Cobb角與手術(shù)復(fù)位后Cobb角度改變、術(shù)前1天術(shù)后3月以及術(shù)后1年疼痛視覺(jué)模擬量表(Visual analogue scale VAS)評(píng)分,以及術(shù)后隨訪(fǎng)1年的下腰痛功能障礙指數(shù)(Oswestry disability index ODI)評(píng)分。結(jié)果:經(jīng)Wiltse入路組在手術(shù)時(shí)間、術(shù)中出血量、術(shù)后引流量、住院時(shí)間、住院總費(fèi)用、術(shù)后3月術(shù)后1年視覺(jué)疼痛VAS評(píng)分上較傳統(tǒng)后正中入路組有明顯優(yōu)越性,術(shù)后1年下腰痛功能障礙指數(shù)ODI評(píng)分無(wú)明顯差異,術(shù)前Cobb角與術(shù)后Cobb角變化差別無(wú)統(tǒng)計(jì)學(xué)意義,(P0.05)。結(jié)論:在掌握手術(shù)適應(yīng)癥的前提下Wiltse入路治療胸腰段椎體骨折,具有醫(yī)源性損傷小、手術(shù)耗時(shí)少、置釘方便、術(shù)中出血少、術(shù)后并發(fā)癥少,符合脊柱微創(chuàng)手術(shù)理念,是一種值得臨床推廣的術(shù)式。
[Abstract]:Objective: to compare the clinical effect of open reduction and internal fixation via Wiltse approach and traditional posterior median approach in the treatment of thoracolumbar vertebral body fracture. Methods: from July 2012 to July 2013, 62 patients (40 males and 22 females) with thoracolumbar fractures were treated by surgical treatment, with an average age of 45.97 years (23 ~ 78 years). All cases were treated with compression fracture of spinal cord injury grade Frankel grade E, burst fracture without nerve symptom and without posterior lamina decompression. Patients in need of surgical treatment were randomly divided into two groups: the traditional posterior median approach group and the Wiltse approach group. The operation time, intraoperative bleeding volume, postoperative drainage volume, hospitalization time, total hospitalization cost were recorded and compared. The changes of preoperative Cobb angle and Cobb angle after surgical reduction, visual analogue scale of pain 1 day before operation, visual analogue scale of pain 1 year after operation, and Oswestry disability index ODI) score of low back pain dysfunction index after 1 year follow up. Results: the operation time, intraoperative bleeding volume, postoperative drainage volume, hospital stay time, total hospitalization cost and VAS score of visual pain 1 month after operation in the Wiltse approach group were significantly superior to those in the traditional posterior median approach group. There was no significant difference in ODI score of low back pain dysfunction index 1 year after operation. There was no significant difference between preoperative Cobb angle and postoperative Cobb angle (P 0.05). Conclusion: the treatment of thoracolumbar vertebral fracture with Wiltse approach under the condition of mastering the indication of operation has the advantages of less iatrogenic injury, less operation time, convenient nail placement, less intraoperative bleeding and less postoperative complications, which is in line with the principle of minimally invasive spinal surgery. It is a kind of operation that is worth popularizing clinically.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

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本文編號(hào)：1943547