Intramuscular space approach versus posterior midline approach in posterior internal fixation of thoracolumbar fractures
Objective:To analyze the advantages and disadvantages of the intramuscular space approach and the posterior midline approach in posterior internal fixation of thoracolumbar fractures.Methods:From January 2010 to December 2022,the clinical data of 328 patients who underwent posterior internal fixation for thoracolumbar fractures at the Army Medical Center of the Chinese People's Liberation Army were retrospectively analyzed.Among these patients,217 underwent the intramuscular space approach(intramuscular space approach group),and 111 underwent the posterior midline approach(intramuscular space approach group).The hospitalization,operation,and hematological indicators of the two groups were compared,and the surgeons'subjective perception scores for the surgical approaches were also compared.Results:Compared with in the posterior midline approach group,patients in the intramuscular space approach group had shorter operation times,less intraoperative rehydration volume and postoperative drainage volume,and lower hospital cost(all P<0.05).However,there were no significant differences in incision length,intraoperative blood loss,hospitalization duration,volume of intraoperative blood transfusion,number of postoperative ICU transfers,number of postoperative infections,or number of the second-phase renovations(all P>0.05).There were also no statistically significant differences in the abnormal levels of potassium ions,urea,creatinine,aspartate aminotransferase,alanine aminotransferase,erythrocyte sedimentation rate,hemoglobin,hematocrit,or C-reactive protein before and after surgery between the two groups(all P>0.05).The subjective perception scores of surgeons for the posterior midline approach were significantly higher than those for the intramuscular space approach in the terms of the main surgeon's visual field,assistant's visual field,hooks,pedicle screw placement,connecting rods placement and suturing(all P<0.05).Conclusions:The intramuscular space approach is superior in the operation time,intraoperative rehydration volume,postoperative drainage volume,and hospital cost,while the posterior midline approach is superior in the comfort of the surgeon during the operation.
Spinal FracturePosterior Spine SurgeryIntramuscular Space ApproachPosterior Midline Approach
万方数据
维普
