摘要
目的探讨经Wiltse肌间隙入路椎弓根钉内固定技术结合快速康复外科(ERAS)治疗无神经损伤胸腰椎骨折的效果。方法选择2018年1月—2019年1月我院60例无神经损伤胸腰椎骨折患者作为研究对象,均采用经Wiltse肌间隙入路椎弓根钉内固定技术联合ERAS治疗。记录临床指标、比较手术前后患者影像学指标、疼痛程度、腰椎功能。结果术后患者下床活动时间为(5.53±1.42)d,镇痛药物剂量为(10.29±1.58)mg,术后术区疼痛持续时间为(2.25±0.62)d。患者术后椎体前缘高度高于术前,Cobb角、视觉模拟评分法(VAS)评分低于术前,日本骨科学会(JOA)评分高于术前,差异均有统计学意义(P<0.05)。结论无神经损伤胸腰椎骨折采用经Wiltse肌间隙入路椎弓根钉内固定技术结合ERAS治疗的复位效果较好,并可有效缓解术后疼痛程度,改善腰椎功能。
Objective To investigate the effects of Wiltse muscle gap approach of pedicle screw internal fixation combined with postoperative enhanced recovery after surgery(ERAS)in treatment of thoracolumbar vertebral fracture without nerve injury.Methods 60 patients with thoracolumbar vertebral fracture without nerve injury who were admitted in the hospital from January 2018 to January 2019 were selected as the subjects.All the patients underwent Wiltse muscle gap approach of pedicle screw internal fixation combined with ERAS treatment.The clinical indexes were recorded,and the imaging indexes,degree of pain,and spinal cord function were compared before and after surgery.Results The off-bed activity time,dosage of analgesic drug and postoperative duration of pain in surgical site were(5.53±1.42)d,(10.29±1.58)mg,(2.25±0.62)d.The postoperative anterior vertebral height of patients after surgery was higher than that before surgery,the Cobb angle and visual analogue scale(VAS)were lower than those before surgery,and the score of Japanese Orthopaedic Association(JOA)was higher than that before surgery,and the difference was statistically significant(P<0.05).Conclusion Wiltse muscle gap approach of pedicle screw internal fixation combined with ERAS in treatment of thoracolumbar vertebral fracture without nerve injury has better reduction effects,which can effectively relieve postoperative degree of pain and improve spinal cord function.
作者
刘文辉
钟恩春
廖主荣
康丽萍
Liu Wenhui;Zhong Enchun;Liao Zhurong(The Second Hospital of Xingguo County,Xingguo,Jiangxi 342400)
出处
《基层医学论坛》
2020年第35期5069-5070,共2页
The Medical Forum
