摘要
目的：探讨胸腰段脊柱骨折前路手术技术改良的方法及可行性。方法：因椎管占位、严重后突畸形、需行前路手术减压植骨内固定的78例新鲜胸腰段脊柱骨折分为改良组（A组）和传统组（B组）。A组41例，男26例，女15例；年龄17～58岁，平均38．27岁；Cobb角10°-40°，平均24．71°；椎管占位率35％～80％，平均49．1％；采用倒V形切口，前路减压、钛网植骨内固定。B组37例，男22例，女15例；年龄18—57岁，平均38．73岁；Cobb角15°～38°，平均25．08°；椎管占位率33％～79％，平均48．3％；采用传统前路减压、自体髂骨植骨内固定。两组均采用Z-Plate钉板内固定。对两组间手术时间、出血量、输血量、手术并发症、植骨融合时间、Cobb角、椎管占位率进行统计学处理。结果：A组39例获平均26个月随访（8～44个月），B组36例获平均27个月随访（9—38个月）；两组间在性别、年龄、骨折类型、植骨融合时间、Cobb角、椎管占位率方面无统计学差异（P〉0．05）。但在手术时间、失血量、输血量、手术并发症方面有显著统计学差异（P〈0．01）。结论：通过改良手术入路，优化手术操作程序，改变植骨方式，能有效地减少胸腰段脊柱骨折前路手术的手术时间、失血量、输血量、降低手术难度及风险和手术并发症。
Objective：To study the methods of modified technique for anterior operation of thoraeolumbar fracture. Methods：Seventy-eight patients of thoraeolumbar fracture were divided into two groups. In group A,41 patients（26 male and 15 female;the average age of 38.27 years ranging from 17 to 58 years;the mean Cobb angle of 24. 71° ranging from 10° to 40°; spinal canal occupational ratio from 35% to 80% , mean 49. 10% ）were treated by through＂ V＂ shape surgical incision, anterior approach decompression and Ti mesh bone transplantation and fixation. In group B,37 patients （22 male and 15 female;the average age of 38.73 years ranging from 18 to 57 years;the mean Cobb angle of 25.08° ranging from 15° to 38° ;spinal canal occupational ratio from 33% to 79% , mean 48.30% ） were treated through traditional anterior approach decompression, iliae bone autograft and fixation. All patients of two groups were fixed with Z-Plate system. Operative time, blood loss, blood transfusion, complication, fusion time, Cobb angle and spinal stenosis （ P 〉 0. 05 ） of two groups were compared through statistical test. Results： In group A ,39 patients were followed-up for 8 to 44 months （average 26 months）. In group B,36 patients were followed-up for 9 to 38 months （average 27 months）. There were no significant differences between two groups regarding the sex, age, type of fractures, fusion time, Cobb angle and spinal stenosis（ P 〉 0. 05 ）. But there were significant differences between two groups regarding the operation time, blood loss, blood transfusion, complication （ P 〈 0.01 ）. Conclusion ： Modified anterior approach and surgical procedures is helpful to reduce operative injuries, complications, blood loss and blood transfusion.
出处
《中国骨伤》
CAS
2006年第8期461-463,共3页
China Journal of Orthopaedics and Traumatology
关键词
胸椎
腰椎
脊柱骨折
外科手术
Thoracic vertebrae
Lumbar vertebrae
Spinal fractures
Surgical procedures, operative
