经Wiltse椎旁肌间隙入路手术治疗胸腰椎爆裂骨折
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作者Author单位AddressE-Mail
蔡福金 CAI Fu-jin 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
骆宇春 LUO Yu-chun 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China luoyuchun101@163.com 
朱建平 ZHU Jian-ping 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
于晓华 YU Xiao-hua 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
刘晓晖 LIU Xiao-hui 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
李宏 LI Hong 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
储旭东 CHU Xu-dong 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
胡一平 HU Yi-ping 解放军第101医院骨科,江苏 无锡 214044 Department of Orthopaedics, the 101st Hospital of PLA, Wuxi 214044 Jiangsu, China  
期刊信息:《中国骨伤》2012年,第25卷,第12期,第980-983页
DOI:10.3969/j.issn.1003-0034.2012.12.003
基金项目:
中文摘要:

目的:探讨Wiltse经椎旁肌入路手术治疗胸腰爆裂骨折的临床疗效及优势。

方法:自2008年6月至2010年6月,对手术治疗的53例无明显神经损伤的胸腰椎爆裂骨折患者进行回顾性分析,男43例,女10例,平均41岁(19~62岁).节段分布:T11 6例,T12 11例,L1 22例,L2 14例。其中28例采用经椎旁肌间隙入路,25例采用传统后正中入路。比较两种手术入路的手术时间、术中出血量及术后引流量,并对患者手术前后腰背部VAS评分、伤椎Cobb角和椎体前部塌陷程度的变化以及伤椎椎管正中矢状径变化进行分析。

结果:经椎旁肌间隙入路手术与传统后正中手术相比,无论在手术时间、术中出血量、术后引流量还是在腰背痛的视觉模拟评分改善等方面都具有明显优势,两种入路在伤椎Cobb角改善、椎体前缘高度恢复和椎管正中矢径变化方面无明显差异。

结论:经椎旁肌间隙入路内固定治疗胸腰椎爆裂骨折可以达到传统后正中入路手术相同的整复效果,而且具有手术创伤小、出血少、操作简便、术后功能恢复快的优点,值得推广。
【关键词】脊柱骨折  手术入路  骨折固定术,内
 
Surgical treatment of thoracolumbar burst fractures through Wiltse paraspinal approach
ABSTRACT  

Objective:To investigate clinical effects and advantages of Wiltse paraspinal approach to thoracolumbar burst fractures.

Methods:From June 2008 to June 2010,the data of 53 patients with thoracolumbar burst fractures with no obviously nerve injury were retrospectively analyzed,including 43 males and 10 females with an average age of 41 years (ranged,19 to 62 years). For segmental distribution,6 cases were T11,11 cases were T12,22 cases were L1 and 14 cases were L2. Among them,28 cases were treated with Wiltse paraspinal approach,and 25 cases with postmiddle approach. The operation time,blood loss,postoperative drainage,VAS score of back,Cobb angle of injured cord,changes of collapse of vertebral and median sagittal diameter of injured vertebral were observed.

Results:Compared with two methods,there were advantages in improving operation time,blood loss,postoperative drainage and VAS score of back,but there were no significant differences in improving Cobb angle of injuried cord,changes of collapse of vertebral and median sagittal diameter of injuried vertebral.

Conclusion:Wiltse paraspinal approach to thoracolumbar burst fractures can achieve the same reduction with postmiddle approach,and has advantages of minimally invasive,less blood,simple operation and rapid recovery,and worth popularizing.
KEY WORDS  Spinal fractures  Operative approach  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:蔡福金,骆宇春,朱建平,于晓华,刘晓晖,李宏,储旭东,胡一平.经Wiltse椎旁肌间隙入路手术治疗胸腰椎爆裂骨折[J].中国骨伤,2012,25(12):980~983
英文格式:CAI Fu-jin,LUO Yu-chun,ZHU Jian-ping,YU Xiao-hua,LIU Xiao-hui,LI Hong,CHU Xu-dong,HU Yi-ping.Surgical treatment of thoracolumbar burst fractures through Wiltse paraspinal approach[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(12):980~983
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