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胸腰椎骨折微创与开放脊柱固定术后的肌肉变化:文献综述

Muscular changes after minimally invasive versus open spinal stabilization of thoracolumbar fractures: A literature review.

作者信息

Pishnamaz Miguel, Schemmann Ulrike, Herren Christian, Horst Klemens, Lichte Philipp, Hildebrand Frank, Pape Hans-Christoph, Kobbe Philipp

机构信息

University of Aachen Medical Center, Department of Orthopaedic Trauma, Germany.

出版信息

J Musculoskelet Neuronal Interact. 2018 Mar 1;18(1):62-70.

Abstract

PURPOSE

This review addressed the question of whether minimally invasive surgery after traumatic thoracolumbar spine fractures can reduce paraspinal muscle injury, limit changes in muscular structure and function, and lead to better functional outcome. Special emphasis was given to studies using imaging techniques or electromyography to evaluate the lumbar multifidus muscle structure and function.

METHODS

The authors searched the literature in the PubMed/Medline, EMBASE, by cross-referencing and additional hand search. Included were comparative studies between conventional open and minimally invasive or percutaneous surgical approaches. Twelve studies were included.

RESULTS AND CONCLUSIONS

The literature review supports the assumption that minimally invasive surgery preserves muscles for the early post-operative period, even though the level of evidence is still low. The correlation of changes in muscular structure to pain, strength, disability, and quality of life remains ambiguous and should be addressed in further studies with a focus on the surgical approach.

摘要

目的

本综述探讨了创伤性胸腰椎骨折后微创手术是否能减少椎旁肌损伤、限制肌肉结构和功能的变化,并带来更好的功能结局这一问题。特别强调了使用成像技术或肌电图来评估腰多裂肌结构和功能的研究。

方法

作者通过在PubMed/Medline、EMBASE中检索文献,并进行交叉引用和额外的手工检索。纳入的是传统开放手术与微创或经皮手术方法之间的比较研究。共纳入12项研究。

结果与结论

文献综述支持这样一种假设,即尽管证据水平仍然较低,但微创手术在术后早期能保护肌肉。肌肉结构变化与疼痛、力量、残疾和生活质量之间的相关性仍不明确,应在进一步的研究中以手术方式为重点加以探讨。

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本文引用的文献

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Paraspinal Muscle Atrophy After Lumbar Spine Surgery.腰椎手术后椎旁肌萎缩
Orthopedics. 2016 Mar-Apr;39(2):e209-14. doi: 10.3928/01477447-20160129-07. Epub 2016 Feb 3.

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