目的：探讨无神经损伤胸腰椎骨折经后路多裂肌与最长肌肌间隙入路椎弓根螺钉系统固定的临床疗效。探讨胸腰椎骨折后路内固定的显露方法。方法通过对2009年3月-2013年6月收治的80例无神经损伤胸腰椎骨折分成甲、乙两组，每组40例。采用后路多裂肌与最长肌肌间隙入路椎弓根螺钉系统固定的患者为甲组，采用传统后入路的为乙组。比较两组的临床疗效。结果甲组在手术时间、术中出血量、术后疼痛（VAS评分）、术后积液引流、切口愈合以及并发症方面明显优于乙组，差异有统计学意义（P<0.05)。 cobb角、椎体高度矫正两组比较差异无统计学意义（P>0.05)。结论经后路多裂肌与最长肌肌间隙入路椎弓根螺钉系统固定无神经损伤胸腰椎骨折是确切有效的方法，它具有操作容易、软组织受损轻微、术中术后出血量少、手术时间短、术后恢复快、并发症少等优点。%Objective To investigate the clinical effect of pedicle screw fixation via multifidus and longissimus patium approach in the treatment of thoracolumbar fracture without neurologic injury and discuss its exposure method. Methods 80 patients with thora-columbar fracture without nerve injury admitted between March 2009 and June 2013 were divided into group A and group B with 40 in each one. Pedicle screw fixation via multifidus and longissimus patium approach was performed in the group A, while inter-nal fixation by traditional posterior approach in the group B. The clinical effects were compared between the two groups. Results In terms of operation duration, intraoperative blood loss, VAS score, drainage flow, wound healing and complication, the group A was superior to the group B with statistically significant differences, P<0.05. No statistically significant differences were observed in Cobb angle and vertebral height correction between the two groups, P>0.05. Conclusion Pedicle screw fixation via multifidus and longissimus patium approach in the treatment of thoracolumbar fracture without neurologic injury has exact curative effect and advantages of easy operation, less soft tissue injuries, less blood loss and operation duration, quick recovery and high safety etc.
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