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椎弓根钉经椎旁肌间隙置入修复胸腰椎骨折:矫正效果及生物相容性随访 预览 被引量:7

Pedicle screw fixation through paraspinal approach for thoracolumbar fractures: a follow-up of correction effect and biocompatibility
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摘要 背景:临床修复脊柱胸腰段骨折的过程中可以选择不同的修复入路,其中传统后正中入路会对患者造成较大的创伤,容易导致一定概率不良后果的出现。目的:对比椎弓根螺钉经传统后正中入路与椎旁肌间隙入路置入内固定修复脊柱胸腰段骨折的效果及生物相容性。方法:回顾性分析陕西省核工业215医院2012年12月至2013年12月收治的53例脊柱胸腰段骨折患者的临床资料,按照修复入路分为2组,对照组27例实施传统后正中入路椎弓根螺钉置入内固定,观察组26例实施椎旁肌间隙入路微创椎弓根螺钉置入内固定。修复后随访12个月,观察两组患者的影像学检查结果、疼痛目测类比评分及围手术期相关指标,并进行比较。结果与结论:分别在修复前、修复后即刻以及末次随访对两组患者进行影像学检查,可得两组经过不同的治疗,均获得良好的椎体前缘高度和后凸角矫正效果,但组间比较差异无显著性意义(均P〉0.05),表明两组的椎体前缘高度和后凸角矫正效果相当。修复后24 h,3 d和末次随访观察组患者的疼痛目测类比评分均显著低于对照组(均P〈0.05)。对两组患者的围修复期相关指标进行分析,可得观察组在术中出血量、引流以及修复后卧床时间等方面均较对照组存在显著优势(均P〈0.05)。表明较之传统后正中入路,利用椎旁肌间隙入路微创椎弓根螺钉置入固定脊柱胸腰段骨折可以获得更好的修复效果及生物相容性。 BACKGROUND: Different operation approaches can be selected during the repair of thoracolumbar fractures. Traditional posterior median approach will cause great wound on patients, and easily induces some adverse consequences. OBJECTIVE: To compare the effects and biocompatibility of conventional posterior median approach and paraspinal approach fixation for treatment of thoracolumbar fractures. METHODS: A retrospective analysis was performed on clinical data of 53 cases of thoracolumbar fracture in the Shaanxi Province Nuclear Industry 215 Hospital from December 2012 to December 2013. They were divided into two groups according to approach method. The control group(n=27) received pedicle screw placement fixation through conventional posterior median approach. The observation group(n=26) underwent pedicle screw placement fixation through paraspinal muscle approach. After repair, they were followed up for 12 months. Imaging results, pain score and perioperative relevant indexes were observed and compared in both groups. RESULTS AND CONCLUSION: Imaging examination was conducted before repair, immediately after repair and during final follow-up in both groups. The height of vertebral anterior border and kyphosis correction effect were good after different therapies in both group, but no significant difference was detectable between the two groups(all P〉0.05). These findings suggest that height of vertebral anterior border and kyphosis correction effect were identical between the two groups. Pain visual analog scale score was significantly lower in the observation group than in the control group at 24 hours and 3 days after repair and during final follow-up(all P〈0.05). Perioperative relevant indexes were analyzed in both groups. Intraoperative bleeding amount, drainage and bed time after repair were observed in the observation group, which showed significant advantages as compared with the control group(all P〈0.05). These results confirmed that compared with the traditional posterior
作者 崔威 张勇鹏 张斌 Cui Wei, Zhang Yong-peng, Zhang Bin (Department of Spine Surgery, Shaanxi Province Nuclear Industry 215 Hospital, Xianyang 712000, Shaanxi Province, China)
机构地区 陕西省核工业
出处 《中国组织工程研究》 北大核心 2015年第22期3513-3518,共6页 Journal of Clinical Rehabilitative Tissue Engineering Research
关键词 胸椎 腰椎 骨折 骨钉 内固定器 随访研究 植入物 脊柱植入物 脊柱胸腰段骨折 手术入路 椎旁肌间隙入路 后正中入路 矫正效果 生物相容性 随访 Thoracic Vertebrae Lumbar Vertebrae Fractures Bone Bone Nails Internal Fixators Follow-Up Studies
作者简介 崔威,1975年生,甘肃省人,主治医师,主要从事脊柱外科方面的研究。
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