摘要
目的探讨使用前路手术治疗强直性脊柱炎合并胸腰椎骨折的方法和效果。方法对2002年1月至2006年1月间河北医科大学第三医院脊柱外科收治的12例强直性脊柱炎(ankylosing spondylitis,AS)胸椎骨折的病例进行研究,男10例,女2例。均采用前路内固定手术进行治疗。按照脊柱骨折的AO分型,其中A型5例,B型3例,C型4例;本组胸腰椎骨折发生的部位在T7-L2之间。影像学分类:压缩骨折3例,爆裂骨折6例,混合型2例,牵伸性损伤1例。骨折累及三柱骨性结构者9例。不同程度的脊髓损伤10例。所有患者均行前路手术治疗。收集患者手术时间、出血量、术后神经症状的改善率等指标进行观察。结果术后对12例患者进行平均24.2个月的随访。结果如下:合并脊髓损伤的10例患者,神经系统功能均有恢复,12例患者的骨折部位均已骨性愈合。术中合并脊髓损伤1例,随访期内无内固定松动、脱落等合并症出现。结论手术治疗可以使大多数强直性脊柱炎患者骨折愈合良好,神经系统功能有不同程度恢复,前路钉棒系统治疗效果较好。
Objective To study the surgical treatment of thoracolumbar vertebral fractures in ankylosing spondylitis via anterior approach. Methods Twelve cases of thoracolumbar vertebral fractures and ankylosing spondylitis patients admitted in our hospital were studied retrospectively. There are 10 male and 2 female patients in total. We chose anterior rod system to treat these patients. According the AO classification of the spinal fractures, there are 5 patients with type A, 3 type B and 4 type C. The location of these fractures are located in T7-L2. 3 for compressive fractures, 6 for burst fractures, 2 for mixed fractures. Nine patients＇ fracture involves all three columns. There were 10 patients with spinal cord injury. Collecting data on surgical time, blood lost, neurologic recovery states, et al were collected. Results All of 12 cases were followed up for an average of 24.2 months. The surgical results were as follows：10 spinal cord injury patients got recovery. 12 patients got the bone fusion. Only 1 patient received spinal cord injury in the surgery procedures. There were no complications related to the internal fixation systems. Condusion Surgical intervention, especially anterior rod system may be the proper way to treat this injury. Fracture union and neurological improvement can be achieved in most patients.
出处
《首都医科大学学报》
CAS
2008年第6期677-680,共4页
Journal of Capital Medical University
基金
河北省卫生厅基金(07077)资助科研课题
关键词
脊柱
骨折
强直性脊柱炎
胸椎
内固定
spine
fracture
ankylosing spondylitis
thoracic vertebral
internal fixation
