摘要
[目的]探讨中上胸椎多节段骨折早期后路手术治疗的时机和外科治疗的方法，以便尽早恢复胸椎正常排列、彻底减压、重建胸椎即刻稳定性，解除对脊髓和神经的机械压迫，使患者能尽早进行康复训练及防止继发损伤，为脊髓神经损伤的康复提供有利条件。[方法]17例中上胸椎多节段骨折患者，均在全麻下早期行后路减压、复位、植骨及内固定术。本组男11例，女6例。年龄18～53岁，平均33．8岁。致伤原因：交通事故7例，高处坠落10例。受伤到就诊时间：1～72h，平均15.4h。损伤节段：T5-10节段，其中T5 2例，T6 4例，T7 5例，T8 5例，T9 4例，T10 2例。脊髓功能评价：完全性损伤10例，不完全性损伤7例。[结果]全部患者获得随访，时间6～27个月，平均13．5个月。复位良好，植骨于术后12周均骨性融合，10例不完全性损伤脊髓功能获不同程度改善，其中5例恢复工作或劳动，7例脊髓完全性损伤者临床症状如疼痛、麻木等得到缓解，所有病例未见手术相关并发症发生。[结论]中上胸椎多节段骨折可行早期后路手术，患者能获得满意的复位和即刻稳定性，脊髓功能获不同程度改善。患者能尽早康复训练及防止继发脊髓损伤，为脊髓恢复创造有利条件，部分恢复神经根功能。也便于临床护理，减少并发症的发生。
[objective] to discuss the opportunity and method of the posterior route operation in the upper- middle thoracic fracture to resume the thoracic vertebral normal sequence,decompression completely and reconstruction immediate stability as soon as possible, so as to relieve pressure to spinal cord and nerve and avoid the secondary trauma of spinal cord and nerve and blood vessel and patients can do rehabilitation. [ Method] Seventeen cases of the patients with upper - middle thoracic vertebral fracture were operated on with posterior route early decompression ,fusion ,internal fixation under general anaesthesia. There were 17 cases including male 11 and female 6 with the ages from 18 to 53 years （ average 33.8 years）. The injury reason： 7 cases as traffic accident, l0 cases as falling from high altitude. The time from trauma to hospital were 1 hr. to 72 hrs. （ average 15.4 hrs.） The injured segment of vertebral： T5 -T10 segment,T5 2 cases,T6 6 cases ,T7 5 cases ,T9 4 cases,T10 2 cases. The function evaluation of spinal cord： 10 cases with incompletely neurological defect ,7 cases with completely neurological defect . [ Result] All patients were followed for 6 - 27 months （ average 13.5months）. The thoracic vertebra restoration were contentment and bone fuse were obtained in 12 weeks after operation. 10 cases with incompletely neurological defect got improved postoperatively and 5 cases activity normolly . 7 cases with completely neurological defect got improved of numbness and pain. [ Conclusion] The upper- middle thoracic vertebral fracture can be operated early and the outcome are contentment.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第12期891-893,共3页
Orthopedic Journal of China
关键词
胸椎
骨折
脱位
前路
早期
手术
内固定
lower cervical vertebrae fracture
dislocation
anterior approach
posterior approach
early
operationinternal fixation
