侧前方椎弓根入路治疗晚期胸腰椎椎体骨折脊髓压迫症

Treatment for delayed thoracolumbar fracture with spinal cord compression by transpedicular approach

采用侧前方椎弓根入路治疗１３例晚期胸腰椎椎体骨折脊髓压迫症患者。７例脊髓不完全性损伤患者的神经功能均有改善，６例脊髓完全性损伤患者中有４例神经功能获得改善。文中对晚期脊髓减压的必要性、可行性和手术方法进行了讨论。

Abstract Thirteen patients of the thoracolumbar fracture with complete (6 cases) and incomplete(7 cases)spinal cord injuries were operated by transpedicle approach at 2～24 months after trauma.Previously, seven patients had undergone laminectomy and 7 patients treated with conservative methods.After admission.all patients received spinal cord decompression by using resection of the compressed bony elements through transpedicular approach.Follow-up study for 6～24 months. Postoperative neurologic improvement occurred in all patients with incomplete injuries and 4 of the 6patients with complete injuries. Spinal instablity were not foud postoperatively.So the spinal cord decompression is still useful for the patients with delayed thoracolumbar fracture with spinal cord injuries, even though the patients had complete spinal cord injuries,neurological improvement could be obtained in some of them.