脊柱支撑器治疗胸腰段骨折脱位(合并或不合并脊髓损伤)

Treatment of Fracture-Dislocation of Thoracolumbar Spine with Modified Harrington Instrumentation(with or without spinal cord injury)

自1981年以来,用脊柱支撑器治疗胸腰段骨折脱位14例,其中11例合并完全或不全脊髓损伤。按脊椎的三柱稳定概念,中柱破坏不稳定者7例。用压缩法及撑开法固定各7例。据生物力学分析,压缩法更符合胸腰段固定的要求,除椎体后缘严重粉碎者外,一般应选用压缩法固定。

Fourteen cases of thoracolumbar fracture-dislocation have been treated with Modified mentation since 1981 Harrington Instrumentation since 1981. Eleven cases were complicated with complete or incomplete spinal cord injury. Middle column of the spine, essential in the maintenance of spinal stability according to Dennis classification, was destroyed in 7 cases. Fixation by compression method or distraction method was used in 7 cases each. Four of the 9 eases complicated with complete spinal cord injury and 2 of the 3 eases with incomplete spinal cord injury got recovery of varying degrees. In follow up, it was found that maintenance of position after reduction and preservation of normal curvature of spine were satisfactory in all cases fixed by compression method, whereas dislodgement of hooks in 1 and increased kyphosis in 2 other cases were found in those treated by distraction method. This may illustrate that the compression method can yield more accurate fixation of thoraeolumbar spine and is therefore to be preferred, except in the cases of communited fracture of posterior 1/3 of vertebral body.