上腰椎爆裂型骨折外侧入路的手术方法

Operative method of lateral approach of superior lumbar burst fracture

目的:介绍上腰椎爆裂型骨折外侧入路的手术方法.方法:沿骶棘肌外缘切口,分离暴露L1、2、3横突,切除横突、椎弓根、椎体后缘和突出的椎间盘,减压硬膜管,并同时作椎体间植骨骨水泥固定.结果:50例患者均能达到脊髓前减压彻底和椎体间植骨融合稳定的目的.截瘫和下肢神经症状的恢复根据Frankel标准,一般均能恢复1～2个档次.结论:上腰椎爆裂型骨折外侧入路的手术方法,能达到脊髓前减压彻底和椎体间植骨融合稳定的目的.

Objective:To introduce the operative method of lateral approach for superior lumbar burst fracture. Method: Along the lateral margin of sacrospinalis to incise and expose the transvers processus of L 1、2、3, the transvers processus, pedicle, vertebral body post margin and herniated disc were all excised and decompressed dural sac, then in intervertebral body to do bone graft and fix it with bone cement. Result: Fifty cases all achieved perfect decompression of anterior spinal cord and intervertebral body bone graft fusion. Evaluation was done according to criterion of Frankel, paraplegia and neural symptom of lower limb were recovered 1~2 grade. Conclusion: Operative method of lateral approach for superior lumbar burst fracture,can lead to perfect decompression of anterior spinal cord and better intervertebral body bone graft fusion.