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目的:探讨多裂肌间隙入路和经皮入路分别联合伤椎置钉治疗无神经损伤胸腰段椎体骨折的临床疗效。方法:回顾性分析苏州大学附属第一医院2015年1月—2018年1月采用多裂肌间隙入路和经皮入路分别联合伤椎置钉治疗无神经损伤的胸腰段椎体骨折的52例患者的临床资料。经多裂肌间隙入路患者25例(A组)，男19例、女6例，年龄35～67 (49.84±9.11)岁；经皮入路患者27例(B组)，男20例、女7例，年龄21～66(48.44±11.02)岁。比较两组患者一般资料，以及手术出血量、手术时间、术后镇痛药物使用率、术后下地时间及术后住院时间；手术前后不同时间点的腰背部疼痛视觉模拟评分(VAS)；比较两组手术前、术后下地前及术后12个月时伤椎前缘高度比值和矢状位Cobb角变化。结果:两组患者一般资料比较差异均无统计学意义(n P值均>0.05)。均顺利完成手术，术后随访12个月。A组的手术时间、术后下地时间分别为120(90，136)min、2(1，3)d，均短于B组的144(110，220)min、4(2，5)d，差异均有统计学意义(n P值均0.05). The operative time and postoperative grounding time in group A were shorter than those in group B [120 (90, 136) min vs. 144 (110, 220) min, 2 (1, 3) days vs. 4(2, 5) days, respectively], and the difference was statistically significant (alln P values<0.05). The number of patients using analgesic drug in group B was higher than that in group A (15 vs. 2), and the difference was statistically significant (P 0.05). The VAS scores of both groups were significantly improved after operation compared with those before operation, and the difference was statistically significant (alln P values0.05); however, the VAS score in group A was better 3 days after surgery, and the difference was statistically significant (n P<0.05). In both groups, the anterior height of the injured vertebra and Cobb angles of the sagittal plane were significantly restored immediately after surgery and after 12 months compared with those before operation, and the difference was statistically significant (alln P values0.05).n Conclusions:Percutaneous and multi-fissure approach combined with vertebral screw placement have good effects on the treatment of single-segment thoracolumbar vertebral fractures without nerve injury. No significant difference was observed in the improvement of fracture deformity and long-term low back pain. Compared with the multi-fissure muscle approach, the percutaneous approach has longer operation time, more serious short-term low back pain, and delayed postoperative grounding time and thus has no significant advantages.