摘要
目的探讨胸腰段脊柱骨折合并脊髓神经损伤患者不同入路减压手术的疗效。方法选取2010-03—2016-09到我院就诊的胸腰段脊柱骨折伴神经损伤的116例患者,分为前路及后路组,前路手术中采用椎体次全切除加钛网及Z板的内固定,后路采用传统后路切开减压钉棒系统内固定治疗;评价指标包括手术持续时间、失血量、手术切口长度、Oswestry残疾指数、后凸畸形矫正、矢状位排列等。结果后路手术组手术时间及失血量显著低于前路手术组,而2组切口长度及术后神经损伤评分无显著差异(P>0.05);随着随访时间的延长后路手术组出现矫正角度的恶化。结论胸腰段脊柱骨折合并脊髓神经损伤患者前路固定能够达到良好的固定效果,但手术相对复杂且创伤性较大,需结合患者的临床表现及骨折分型具体分析,选择恰当的手术入路。
Objective To investigate the curative effects of different approaches of decompression on patients with thoraco- lumbar spine fracture and spinal cord injury. Methods All 116 patients meeting the included criteria from January 2010 to June 2016 were divided into anterior-approach and posterior-approach groups. The former carried out subtotal vertebrectomy, subsequ- ent supplementation with titanium cage and internal fixation with Z plate, while the latter used traditional incisioin decompression and internal fixation via posterior screw-rod system. Evaluation indexes included operation duration, blood loss, incision length, Os- westry disability index,correction of kyphotic deformity,sagittal alignment,etc. Results Operation time and blood loss in the pos- terior-approach group were significantly lower than those in the anterior-approach group, but there were no significant differences as for nerve injury scores and postoperative incision length between the two groups（P〉0.05）. With the prolonged follow-up, the posterior-approach group presented the deterioration of corrective angle. Conclusion Although internal fixation via anterior ap- proach can have a good effect on the treatment of thoracolumbar spine fracture and spinal cord injury, this approach is relatively bigger complex and invasive. We should seriously analyze and choose appropriate operation approach based on specific clinical man- ifestations and precise fracture types.
出处
《中国实用神经疾病杂志》
2017年第8期9-12,共4页
Chinese Journal of Practical Nervous Diseases
基金
河南省科技发展计划
编号:142300410297
