Paraspinal approach and posterior median approach for one-stage decompression reconstruction in the treat-ment of thoracolumbar spine fracture and dislocation
10.11659/jjssx.07E015112
- VernacularTitle:椎旁肌间隙入路与后正中入路行一期减压重建治疗胸腰段脊柱骨折脱位
- Author:
Guihua YU
;
Jun CHEN
;
Fusheng XIANG
;
Weixing SHI
- Publication Type:Journal Article
- Keywords:
spine fracture and dislocation;
thoracolumbar;
one-stage decompression reconstruction;
paraspinal approach;
curative effect
- From:
Journal of Regional Anatomy and Operative Surgery
2016;25(3):208-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of paraspinal approach and posterior median approach for one -stage decompression recon-struction in the treatment of thoracolumbar spine fracture and dislocation .Methods From January 2012 to January 2014, 60 patients with thoracolumbar spine fracture and dislocation who were admitted and treated in our hospital were selected as the research objects .All patients received one-stage decompression reconstruction for treatment .According to the methods of approach , the patients were divided into the ob-servation group and the control group .The 30 cases in observation group were treated by paraspinal approach while the other 30 cases in con-trol group were treated by posterior median approach .Visual analogue score ( VAS) was applied .The status of surgery , recovery of centrum height, changes of Cobb angle as well as the occurrence rate of postoperative complications in the two groups were recorded .Results In the observation group, the operative time, time in bed and length of stay were (89.16 ±11.63) min, (39.75 ±8.69) h and (3.96 ±1.04) d respectively, which were shorter than those in the control group .The intraoperative blood loss was (89.64 ±13.62) mL which was lower than that in the control group and the difference was significant (P<0.05).One week after operation, the anterior and posterior height of centrum in the observation group increased significantly while Cobb angle significantly reduced .Compared with those before the treatment , the difference was significant (P<0.05).The maximum coronary diameter and maximum sagittal diameter of paraspinal muscles in the ob -servation group after the treatment were (48.96 ±5.34)mm and (18.16 ±6.74)mm respectively, which were significantly higher than those in the control group and the difference was significant (P<0.05).The incidence of lumbar and back pain in the observation group was 3.33%which was lower than 23.33%in the control group and the difference was statistically significant (P<0.05).Conclusion To carry out decompression reconstruction through paraspinal approach can reduce the the pain degree of patients and the incidence of lumbar and back pain after operation .
