脊髓损伤的早期后路椎管重建

Remodeling of the spinal canal in early stage spinal cord trauma via posterior approach

目的 :评价脊椎骨折后路手术对受侵犯椎管的复位与重建作用。方法 :5 2例急性胸腰椎骨折 /脱位患者经影像学检查和神经功能评分 ,急诊行后路减压复位椎弓根钉棒系统内固定。平均随访 12 .5个月。结果 :术前 5 2例患者椎管受侵犯 ,平均狭窄 45 .7% ,脊柱后凸畸形平均角度为 19.6°。术后椎管狭窄程度显著降低到 16.2 % ,脊柱后凸畸形降低至 9.5° ( P<0 .0 5 )。 45例神经功能改善 ,7例没有改善 ,有效率 86.5 %。结论 :胸腰椎骨折 /脱位可在早期经后路手术椎弓根钉棒系统固定达到减压和早期椎管重建。

Objective: To evaluate the reduction of spinal canal encroachment and subsequent remodeling by posterior operation in early stage of spinal trauma. Methods: Radiographic examination and functional scores were evaluated in 52 patients with acute thoracolumbar and lumbar fractures with intraspinal fragments. Patients were treated by posterior pedicle instrument. Mean follow up period was 12.5 months. Results: Preoperatively, there was significant canal encroachment in 52 patients(average straitness 45.7%); Postoperatively, it was reduced to 16.2%. There was a statisticall difference between postoperation and preoperation. The mean preoperative kyphotic deformity was 19.6°. Postoperatively, it was reduced to 9.5°. Neurological function in forty five paients were improved, and 7 patients remained unchanged during follow up. Conclusion: Effective decompression and remodeling of the canal deformed in patients with acute spine and spinal cord injury can be achieved by posterior pedicle instrument and neurological function can be improved.