目的:脊柱后路稳定与医源性肌肉损伤有关。这被讨论为代表术后疼痛的重要原因,尤其是切开复位和固定。这项研究的目的是可视化创伤性胸腰椎脊柱骨折的开放或经皮后路稳定后的肌肉变化,并研究这些变化是否与临床结果有关。
方法:本前瞻性队列研究于2012年5月至2014年10月进行。一组后稳定的患者(研究组;SG)患有胸腰椎交界处(T11-L2)的创伤性骨折(A0SpineA3或A4型),没有神经功能缺损,按年龄与健康对照组(CG)相匹配。性别和体重指数。
结果:术后12个月。
方法:肌肉大小,使用标准化超声方案和标准化问卷(VAS脊柱评分;ODI;SF-36)分析了自愿肌肉激活(VMA)。
方法:SPSS(第20版,76芝加哥,IL,美国)。T试验,卡方检验,进行方差分析和相关分析.显著性水平为p<0.05。
结果:包括25名患者(SG)和23名对照个体(CG)。在后续行动中,与对照组相比,所有患者腰椎多裂肌(LM)和腹横肌(TrA)的自愿性肌肉激活均减少(L3/4级VMALM:SG3.2%;CG5.1%;p<0.05;VMATrA:SG33.43%;CG37.84%;p<0.05).与对照组相比,伴随访谈显示所有患者的健康限制。肌肉功能与临床结果之间的相关性未得到证实(rs>0.07;NS)。
结论:在手术治疗的A3和A4骨折中,如超声和临床对照所记录的,手术后1年存在持续的肌缺陷.但是,通过我们的研究,我们得出的结论是,这些肌肉缺陷对于手术后1年的临床结局似乎并不是决定性的.
OBJECTIVE: Posterior stabilization of the spine is associated with iatrogenic muscle damage. This is discussed to represent an important cause of postoperative pain, especially in open reduction and fixation. The aim of this
study was to visualize muscular changes after open or percutaneous posterior stabilization of traumatic thoracolumbar spine fractures and to investigate whether or not these changes are related to the clinical outcome.
METHODS: This prospective cohort
study was performed between 05/2012 and 10/2014. A group of posteriorly stabilized patients (
study group; SG) with traumatic fractures (AOSpine Type A3 or A4) of the thoracolumbar junction (T11-L2) without neurological deficit were matched to a healthy control group (CG) by age, gender and body mass index.
RESULTS: 12 months after surgery.
METHODS: muscle size, voluntary muscular activation (VMA) using a standardized ultrasound protocol and standardized questionnaires (VAS Spine Score; ODI; SF-36) were analyzed.
METHODS: SPSS (Version 20, 76 Chicago, IL, USA). T test, Chi squared test, analysis of variance and a correlation analysis were performed. Significance level was at p < 0.05.
RESULTS: Twenty-five patients (SG) and 23 control individuals (CG) were included. At follow-up, voluntary muscular activation of the lumbar multifidus (LM) as well as the transverse abdominis muscle (TrA) was diminished in all patients compared to the control group (VMA LM at level L3/4: SG 3.2%; CG 5.1%; p < 0.05; VMA TrA: SG 33.43%; CG 37.84%; p < 0.05). Concomitant interviews revealed health restrictions in all patients when compared with the control group. A correlation between muscle function and clinical outcome could not been demonstrated (rs > 0.07; NS).
CONCLUSIONS: In surgically treated A3 and A4 fractures, there is continuous muscular deficit 1 year after surgery as documented by ultrasound and clinical control. But, by means of our
study we conclude that those muscular deficits alone seem not to be decisive for the clinical outcome 1 year after surgery.