侧前路减压、脊柱重建治疗胸腰段椎体爆裂骨折

Use of Anterolateral Decompression and Spinal Reconstruction for Thoracolumbar Vertebrae Burst Fracture

目的 探讨胸腰段椎体爆裂骨折侧前路减压与重建的临床效果。方法 对 19例胸腰段椎体爆裂骨折侧前路减压及髂骨、肋骨、钛网植骨加 Z- plate、Kaneda内固定系统重建脊柱稳定的临床资料进行总结。结果 经平均 13个月随访 ,术后脊柱序列及生理曲度恢复正常 ,椎管无占位 ,植骨融合良好 ,无继发性后凸畸形发生 ,无钢板、螺丝钉断裂及松动等并发症。结论 侧前路手术可一期实现椎管前方减压 ,且直接、彻底 ,使神经获得最大限度的功能恢复 ,Z-plate、Kaneda内固定直接作用于骨折部位可以对椎体间支撑和对植骨加压 ,促进植骨融合 。

Objective To investigate the clinical effects of anterolateral decompression and reconstruction in the thoracolumbar burst fracture.Methods 19 cases with thoracolumbar burst fracture were treated by anterolateral decompression, intervertebral bone grafting with ilium costa titanium mesh, and fixation with Z-PLATE or KANEDA system.Results After average follow up for 13 months, the spinal sequence and the thoracolumbar spinal curvature was restored to normal.There was no occupation in the vertebral canal.The grafted bone has good fusion.There was no complication in our case, such as secondary posterior process abnormality, break or mobilization of plate screw, et al.Conclusion Not only anterolateral route operation could decompress the vertebral canal directly and thoroughly, but also make the nerves to obtain maximal functional recovery.Z-PLATE and KANEDA fixed directly on the fracture bone compress the grafted bone, support the intervertebral bone, and facilitate the bone fusion.It is adapted to rabuild the stability and restores the function of the reconstructed thoracolumbar burst fracture during early period.