摘要
目的探讨经前路减压、椎间植骨融合内固定术治疗胸腰椎爆裂骨折的疗效。方法对22例胸腰椎爆裂骨折患者行前路减压、椎间植骨融合内固定术,并对患者神经功能、骨折愈合情况进行术前术后对比分析。结果平均手术时间3.5h,平均失血量800ml,平均住院时间10d。平均随访18个月,脊柱稳定性好,序列好,未出现螺钉松动、钛网下沉等并发症,植骨均愈合。末次随访时神经功能均较术前恢复1～3级。结论经前路减压植骨融合内固定术治疗胸腰椎爆裂骨折能彻底减压,植骨融合率高,固定效果好,神经功能改善明显,具有推广应用价值。
Objective To explore the clinical efficiency of the treatment of the thoracolumbar spina burst fracture through planted bones fusion and internal fixation by anterior decompression.Methods Between January 2008 and December 2010,22 cases of thoracolumbar spina burst fracture were treated by planted bones fusion and internal fixation by anterior decompression,including 16 males and 6 females with an age range of 22-65 years（44.5 years on average）.The injury was caused by fall from height in 12cases,by traffic accident in 8 cases and by weight crushing in 2 cases.The injury segments were 2 cases of thoracic 11,8 cases of thoracic 12,10 cases of lumbar 1 and 2 cases of lumbar 2.Preoperative CT showed that all 22 cases suffered from spinal canal occupancy,fracture fragments migrated into spinal canal and spinal dura mater compression.There are 4 cases of Grade A,6 cases of Grade B,8 cases of Grade C,2 cases of Grade D and 2 cases of Grade E according to Frankel grading of neurologic status before surgery.It was an average of 6.5 days from injury to operation.The mean operative time was 3.5 hours and the mean blood loss was 800 ml.The mean time in hospital was 10 days and the mean follow-up time was 18 months.The comparative analysis before and after surgery of all patients in neurologic status and fracture healing were studied.Results Spinal stability and sequence are good without complications such as screws loosing or titanium nets sinking.All the planted bones healed.The neurologic status restored to 1-3 grade as compared with those of before surgery in the final follow-up.Conclusion The method of planted bones fusion and internal fixation by anterior decompression has a more thorough effect in decompression,and higher planted bones fusion rate and better internal fixtation.The efficiency of the treatment of the thoracolumbar spina burst fracture through planted bones fusion and internal fixation by anterior decompression is good.
出处
《西部医学》
2012年第8期1479-1480,1483,共3页
Medical Journal of West China
关键词
胸腰椎
爆裂骨折
前路减压
椎间植骨
Thoracolumbar spina
Burst fracture
Anterior decompression
Interverbral implanted bone
