摘要
目的观察改良胸腰椎前路手术径路及内固定技术治疗胸腰椎爆裂骨折的效果。方法胸腰椎爆裂骨折患者52例，其中新鲜骨折47例，陈旧骨折5例，均采用倒“L”形手术径路，电凝烧结或结扎椎体节段血管，切除伤椎相邻上、下椎间盘，保留大部分软骨终板后置放椎体螺钉，取髂骨块，再切除伤椎行椎管减压，撑开椎间隙行髂骨块植骨，置放钢板矫形固定。结果其中新鲜骨折47例，术中出血300—700ml，平均490ml，手术时间120—210min，平均156min；陈旧性骨折5例，术中出血800—1100ml，平均1050ml，手术时间210—240min，平均217min。48例患者术后随访9～18个月，平均13个月，脊柱序列均恢复正常，无植骨块塌陷及高度丢失现象，无内固定失败；脊髓神经功能均有不同程度的恢复。结论改良胸腰椎前路手术径路及内固定技术可明显减少术中出血，缩短手术时间，减轻手术创伤，降低了术后并发症的发生率。
Objective To observe modified anterior approach incision and inner fixation technique for thoraeolumbar vertebral bursting fracture. Methods Inverted ＂L＂ shape Incision was applied, meanwhile vertebral segment vessels was cut or ligated and intervertebral disc of fracture vertebra was removed. Results Fifty-two cases with thoracolumbar vertebral bursting fracture were treated. The incisions ranged between 14 and 20 cm （mean 17 cm）. Forty-seven cases got fresh fracture and blood loss was 300-700 ml （ mean 490 ml）. The operation duration was 120-210 min （mean 156 min）. 5 cases had old fracture with blood loss 800-1100 ml（ mean 1050 ml）. The operation duration was 210-240 min. During follow-ups, the bone graft sinking and loss of deformity correction was not found. The spinal nerves function gained different levels of recovery. Conclusion The modified anterior approach incision and inner fixation technique for thoracolumbar vertebral decrease blood loss, shorten operating time with reduced trauma and less complications.
出处
《中国医药》
2009年第3期201-202,共2页
China Medicine
关键词
爆裂骨折
胸椎
腰椎
Bursting fracture
Thoracic vertebra
Lumbar vertebra
