摘要
目的观察比较前、后手术入路治疗上胸段脊柱病变的疗效。方法选择上胸段脊柱病变56例,其中肿瘤27例,结核23例,陈旧性外伤6例,分别经前、后路病灶切除减压、植骨,大部分(48例)辅以内固定。随访6～48个月。结果本组均安全度过围手术期,3例术后发生乳糜漏,4例出现喉返神经牵拉伤所致一过性声音嘶哑,4例出现一过性膈神经刺激引起的呃逆症状。48例术后神经功能有不同程度改善,8例无明显改善。随访期间1例于1个月后双侧肺炎死亡,2例局部肿瘤复发,2例局部结核复发,1例肿瘤细胞全身转移死亡。均无断钉及内固定脱落。结论对上胸段脊柱病变正确选择应用前、后入路手术可暴露病变部位,彻底清除病灶。
Objective To compare the results of the surgical treatment for process lesion located in upper thoracic vertebrae by anterior and posterior approach. Methods Fifty- six patients with process lesion located in upper thoracic vertebrae were observed,including 27 patients with tumor,23 with tuberculosis and 6 with obsolete trauma. Each patient underwent operation with anterior or posterior resection ,spinal cord decompression and bone graft. Forty - eight patients were implanted internal fixation. They were followed up from 6 to 48 months. Results All patients survived surgery well. Three patients suffered from chylorrhea,4 suffered from recurrent laryngeal nerve injury and 4 suffered from recurrent hawing for phrenic nerve injury. Forty - eight patients had improvements of the neural symptoms on different degree. One patient died of double pneumonia 1 month later, 1 patient died of distant metastasis,and local tumor relapsed in 2 patients, local tuberculosis relapsed in 2 patients. There was no rupture of the nails or fall of the internal fixation during the follow - up. Conclusion Exactitude choice of anterior and posterior approach might expose the lesion and clear the process thoroughly in upper thoracic vertebrae.
出处
《中国骨与关节损伤杂志》
2008年第9期714-716,共3页
Chinese Journal of Bone and Joint Injury
关键词
上胸椎
脊柱病变
前路
后路
手术
治疗
内固定
Upper thoracic vertebrae
Spine lesion
Anterior approach
Posterior approach
Operation
Treatment
Internal fixation
