摘要
目的对比分析经肌间隙入路复位内固定术与经后路复位内固定椎间融合术治疗胸腰椎骨折的临床效果。方法选取2020年3月至2021年2月嵩县西关骨科医院收治的76例胸腰椎骨折患者作为研究对象,按照随机数表法将其随机分为肌间隙组(38例)和后路组(38例),肌间隙组患者采用经肌间隙入路复位内固定术治疗,后路组患者采用经后路复位内固定椎间融合术治疗,对比观察两组患者手术时间、术中出血量、椎体前缘高度比、后凸角角度、椎体功能与术后并发症发生情况。结果肌间隙组患者手术时间明显短于后路组(t=7.845,P<0.001),术中出血量明显少于后路组(t=6.061,P<0.001);术后3个月,肌间隙组患者椎体前缘高度比、后凸角角度及Oswestry功能障碍指数(ODI)评分与后路组无明显差异(t=1.201、1.523、1.081,P=0.234、0.132、0.283);肌间隙组患者术后并发症发生率为10.53%,与后路组患者的术后并发症发生率5.26%无明显差异(χ^(2)=0.724,P=0.395)。结论经肌间隙入路复位内固定术与经后路复位内固定椎间融合术治疗胸腰椎骨折均可取得满意的临床效果,但经肌间隙入路复位内固定术的手术时间更短、术中出血量更少。
Objective To compare the clinical efficacy of reduction internal fixation by intermuscular space approach and posterior-approached reduction internal fixation&interbody fusion in the treatment of thoracolumbar fracture.Methods 76 patients with thoracolumbar fracture,admitted to Songxian Xiguan Orthopaedic Hospital from March 2020 to February 2021,were enrolled as research subjects and then divided,using the random number table,into intermuscular space group(n=38)and pbsterior approach group(n=38).Patients in intermuscular space group were treated with reduction internal fixation by intermuscular space approach,whereas patients in posterior approach group were treated with posterior-approached reduction internal fixation&interbody fusion.The operation duration,intraoperative blood loss,ratio of the height of anterior vertebral edge,kyphosis angle,vertebral function and postoperative complications were observed and compared between the two groups.Results The operation duration of patients was significantly shorter in the intermuscular space group compared with the posterior approach group(t=7.845,P<0.001),and the intraoperative blood loss was markedly less in the intermuscular space group(t=6.061,P<0.001);at month 3 after operation,there were no significant differences in terms of ratio of the height of anterior vertebral edge,kyphosis angle and Oswestry disability index(ODI)scores between the two groups(t=1.201,1.523 and 1.081,P=0.234,0.132 and 0.283);the incidence of postoperative complications was 10.53%in the intermuscular space group,showing no significant difference compared with 5.26%in the posterior approach group(χ^(2)=0.724,P=0.395).Conclusion Both reduction internal fixation by intermuscular space approach and posterior-approached reduction internal fixation&interbody fusion can achieve satisfactory clinical outcomes in the treatment of thoracolumbar fracture,but the operation duration was shorter and intraoperative blood loss was less by the intermuscular space approach.
作者
张利锋
李强
杜凯
ZHANG Lifeng;LI Qiang;DU Kai(Department of Spinal Surgery,Songxian Xiguan Orthopaedic Hospital,Luoyang,Henan 471400,China)
出处
《中国烧伤创疡杂志》
2023年第1期42-45,共4页
The Chinese Journal of Burns Wounds & Surface Ulcers
关键词
胸腰椎骨折
胸椎骨折
腰椎骨折
经肌间隙入路复位内固定术
经后路复位内固定椎间融合术
椎体功能
Thoracolumbar fracture
Thoracic vertebra fracture
Fracture of lumbar vertebra
Reduction internal fixation by intermuscular space approach
Posterior-approached reduction internal fixation&interbody fusion
Vertebral function
