肌间隙人路椎弓根钉固定结合椎体成形术治疗胸腰椎骨折

目的：观察经肌间隙入路椎弓根钉固定结合椎体成形术治疗胸腰椎骨折的临床疗效。方法：对31例新鲜单节段胸腰椎骨折，采用体外过伸手法复位，结合经肌间隙入路椎弓根钉复位、固定，通过伤椎椎弓根注射自固化人工骨水泥，根据术前、术后侧位x线片，测量椎体高度、后凸角，并计算椎体高度的压缩率及后凸角恢复率。结果：31例手术均获成功，术后48h腰背创口VAS疼痛评分明显降低。术后3～8个月自固化人工骨水泥降解骨化，平均13个月拆除内固定，椎体前中柱高度明显恢复，后凸角得到矫正。结论：经肌间隙入路椎弓根钉固定结合椎体成形术是一种治疗胸腰椎骨折的可行性方法，手术创伤小，能恢复伤椎前中柱的力学强度，减少椎弓根钉的失败率。

Treatment of Thoracolumbar Fracture by Combined Stabilization with Pedicle-screw and Vertebroplasty through Approach of Para-vertebral Muscle Sparing

Objective To investigate the surgical technique and clinical outcome of treatment of acute traumatic thoracolumbar fractures through the approach of para-vertebral muscle sparing by transpedicular vertebroplasty with artificial cement and posterior instrumentation.Methods Thirty-one patients,22 males and 9 females,averaging 46 years of age with single level traumatic thoracolumbar fracture with light or without neurologic deficit were prospectively studied.These patients had 22 compression fractures and 9 b...