摘要
目的对比不同入路方式治疗单节段胸腰椎骨折患者的疗效。方法2013年2月—2018年1月黔南州中医医院骨伤一科收治单节段胸腰椎骨折患者128例,男性74例,女性54例;年龄23~58岁,平均39.8岁。根据手术入路不同将患者分为传统正中入路组(n=42)、经皮入路组(n=43)、经椎旁肌间隙入路组(n=43),比较三组患者临床疗效、手术指标、VAS评分、Oswestry功能障碍指数(ODI)、影像学指标、并发症发生率。结果经皮入路组、经椎旁肌间隙入路组的总有效率分别为88.37%、86.05%,均高于传统正中入路组的66.67%(P<0.05),但经皮入路组、经椎旁肌间隙入路组两组临床总有效率比较差异无统计学意义(P>0.05)。经皮入路组手术时间(67.73±7.07)min、住院时间(8.68±1.57)d以及经椎旁肌间隙入路组手术时间(56.19±8.74)min、住院时间(8.76±1.02)d均短于传统正中入路组(108.57±9.48)min、(11.75±1.04)d,经皮入路组、经椎旁肌间隙入路组术中出血量分别为(43.59±9.20)mL、(57.40±8.28)mL,均少于传统正中入路组(102.72±12.07)mL(P<0.05),经椎旁肌间隙入路组手术时间短于经皮入路组,但术中出血量多于经皮入路组(P<0.05)。术后3个月经皮入路组VAS评分(1.24±0.21)分、ODI指数(13.52±1.23)分以及经椎旁肌间隙入路组VAS评分(1.23±0.19)分、ODI指数(13.66±1.63)分均低于传统正中入路组(2.31±0.35)分、(17.64±1.42)分,P<0.05。术后2周、12个月传统正中入路组的伤椎椎体前缘高度为(22.73±3.66)mm、(21.81±4.17)mm,经皮入路组为(22.89±3.44)mm、(21.14±3.05)mm,经椎旁肌间隙入路组为(23.19±4.12)mm、(21.31±4.08)mm,均较术前升高,术后2周、12个月传统正中入路组后凸Cobb角为(13.62±3.08)°、(14.07±1.93)°,经皮入路组为(12.83±2.14)°、(13.53±2.40)°,经椎旁肌间隙入路组为(12.71±2.15)°、(13.77±2.12)°,均较术前降低(P<0.05)。传统正中入路组、经皮入路组、经椎旁肌间隙入路组的并发症发
Objective To compare the effects of different approaches in the treatment of single-level thoracolumbar fractures.Methods Totally 128 patients with single-level thoracolumbar fractures who were admitted to our hospital from Feb.2013 to Jan.2018 were selected as the study subjects.There were 74 males and 54 females,aged 23-58 years,with an average age of 39.8 years.The selected patients were divided into group A(n=42,traditional median approach),group B(n=43,percutaneous approach),and group C(n=43,paravertebral space approach)according to operation methods.The clinical efficacy,surgical index,visual analogue pain score(VAS),Oswestry dysfunction index(ODI),imaging index and complications of the three groups were compared.Results The total effective rate of group B and group C was 88.37%and 86.05%,respectively,which was higher than 66.67%in group A(P<0.05),but there was no significant difference between groups B and C(P>0.05).The operation time(67.73±7.07)min,hospitalization time(8.68±1.57)d in group B and operation time(56.19±8.74)min,hospitalization time(8.76±1.02)d in group C was shorter than(108.57±9.48)min,(11.75±1.04)d in group A,the intraoperative bleeding volume in groups B and C was(43.59±9.20)mL,(57.40±8.28)mL,which was less than that in group A(102.72±12.07)mL(P<0.05).The operation time of group C was shorter than that of group B,but the intraoperative bleeding volume was more than that of group B(P<0.05).The VAS score and ODI score of group B was(1.24±0.21)points and(13.52±1.23)points,the VAS score and ODI score in group C was(1.23±0.19)points and(13.66±1.63)points,which was lower than(2.31±0.35)points and(17.64±1.42)points in group A at 3 months after operation(P<0.05).At 2 weeks and 12 months after operation,the anterior height of injured vertebral body in group A was(22.73±3.66)mm and(21.81±4.17)mm,was(22.89±3.44)mm and(21.14±3.05)mm in group B,and was(23.19±4.12)mm and(21.31±4.08)mm in group C,which was higher than before operation.The Cobb angle of kyphosis in group A was(13.62�
作者
班博恒
覃家永
陆耀宇
杨通宇
程刚
BAN Bo-heng;QIN Jia-yong;LU Yao-yu;YANG Tong-yu;CHENG Gang(First Department of Orthopaedics and Traumatology,Qiannan Prefecture Hospital of Traditional Chinese Medicine,Duyun,Guizhou 558000,China)
出处
《创伤外科杂志》
2019年第12期897-901,907,共6页
Journal of Traumatic Surgery
基金
贵州省黔南州科技基金项目[黔南科合字(2016)037号]
关键词
胸腰椎骨折
单节段
入路
疗效
thoracolumbar fracture
single segment
approach
treatment effect
