胸腰椎压缩性骨折手术治疗中对椎旁肌的保护及短节段稳定

Sukru Oral, Atilla Yılmaz, A. Küçük, H. Ulutabanca, A. Selçuklu
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摘要

目的:在本研究中,采用保留椎旁肌肉、不融合后短节段椎弓根内固定技术治疗胸腰椎骨折。方法:2009-2015年,选取我院收治的24例胸腰椎压缩性骨折患者行短节段后路内固定手术治疗。放射学评价采用脊柱前体高度损失(LHSAC)和局部后凸角(LAK)。在手术中,胸腰筋膜线性打开,筋膜外侧切除,手指在多裂肌和最长肌之间脱位。发现了脊椎动物和人造物体的横向过程。经椎弓根螺钉与c型臂放置。结果:术前测得的局部后凸角平均值为11.03度,一年后测得的局部后凸角平均值为7.24度。术前脊髓前体高度损失(LHSAC)平均为27.21%。第1年末,LHSAC平均值为22.83%。平均手术时间为103.75分钟,平均失血量为123.12 ml。结论:在该手术中,保存椎旁肌肉有助于短节段内固定的脊柱稳定。因此,胸腰椎短节段内固定可显著改善压缩性骨折患者的后凸。
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Protection of Paravertebral Muscles and Short Segment Stabilization in Surgical Treatment of Thoracic and Lumbar Compression Fractures
Objective: In this study, patients with thoracolumbar and lumbar fracture fractures were treated with preservation of the paravertebral muscles, unfused posterior short-segment pedicle instrumentation technique. Methods: Between the years 2009-2015, 24 patients were applied short-segment posterior instrumentation surgery for thoracolumbar and lumbar compression fractures in our clinic included in the study. On radiological evaluation, loss of height in spinal anterior corpus (LHSAC) and local angle of kyphosis (LAK) were used. In the operation, the thoracolumbar fascia opened linearly, fascia was excised laterally and finger-dislocated between the multifidus and longissimus muscles. The transversal processes of vertebrates and manufactured objects were found. The transpedicular screws were placed with the C-arm. Results: The mean local angle of kyphosis measured preoperatively was 11.03 degrees and this angle 7.24 degrees at the end of the first year. Before the operation, loss of height in the spinal anterior corpus (LHSAC) was determined as 27.21% on average. At the end of the 1st year, the mean LHSAC was measured as 22.83%. Mean duration of the operation was 103.75 min and mean blood loss was 123.12 ml. Conclusion: In this surgical procedure, preservation of the paravertebral muscles contributes to vertebral column stabilization in cases of short segment instrumentation. For this reason, short segment instrumentation in thoracic and lumbar locations provides a significant kyphotic improvement in patients with compression fractures.
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