摘要
目的探讨应用后路椎弓根内固定系统复位固定联合前路减压植骨术治疗胸腰椎骨折伴不全瘫的临床疗效。方法应用后路RF或AF复位固定骨折推体,结合前路经胸腹膜外途径椎体减压植骨术治疗胸腰椎爆裂型骨折伴不全瘫32例。结果32例均能耐受手术,并获6～24个月的随访,X线片复查椎体前缘高度恢复,后突角消失,RF或AF螺钉无松动断裂,CT复查椎管减压彻底。32例均在术后2～4周内恢复排尿功能,6个月内两下肢均有Frankle2～3级以上的神经功能恢复。结论①后路RF或AF复位、固定满意,前路手术减压彻底;②后路RF或AF复位内固定联合前路减压植骨术是治疗胸腰椎骨折伴不全瘫的安全有效价廉的手术方式。
Objective To study the treatment effects of thoracolumbar fractures complicated with incomplete paraplegia using transpedicle screw internal fixation system through posterior approach in combination with decompression and bone graft through anterior approach. Methods 32 patients with thoracolumbar fractures complicated with incomplete paraplegia were treated by posterior RF or AF reduction-fixation and anterior decompression and bone graft. Results After follow-ups of 6 months to 2 years, the X-ray demonstrated no screw loosening or breaking, the anterior height of vertebral body got normal, and the vertebral kyphotic deformity disappeared. CT scans showed no spinal canal stenosis. The neurologic functions of the lower limbs had improvement of 2 to 3 grades by Frankel grading system within 6 months after operation. All the patients regained the function of uresis 2 to 4 weeks postoperatively. Conclusions The operation is a simple and ideal technique to treat thoracolumbar fractures complicated with incomplete paraplegia, for the posterior RF or AF reduction and fixation can get satisfactory results and anterior decompression is sufficient.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第8期940-941,共2页
Chinese Journal of Orthopaedic Trauma
基金
江苏省盐城市科技基金资助项目(YK2002019)
