胸腰椎严重骨折的分型与诊治

The typing,diagnosis and therapy of severe thoracolumbar fractures

目的探讨胸、腰椎严重骨折的表述、分类、诊断与手术治疗原则。方法分析本组收治的51例多节段脊椎骨折和脊椎骨折脱位患者,将其归属于严重的脊柱骨折范畴。并对所有病例进行了分类,给出了详细的诊断描述, 对于不同类型的患者采取不同的手术策略。结果 26例平均随访38个月,Frankel分级改善1级者13例,2级者8 例,3级者4例,无改善者1例,未发现有迟发型神经功能障碍者。结论对于胸、腰椎严重骨折我们首先应明确其分型。对于不同的骨折类型结合其术前评估制定不同的手术策略,将对脊柱稳定性及脊髓损伤的恢复起重要作用。

Objective To discuss the expression,typing,diagnosis and surgical treatment principle of severe thoracolumbar fractures. Methods Fifty-one cases of multiple-level spinal fracture and spinal fracture-dislocation were analyzed,whose diseases were subjected to severe spinal fractures. All the cases were classified and given detailed diagnosis description so as to take different operative strategies with regard to different fracture types. Results The results after a follow-up for a period of average three years and two months in 26 cases showed that according to Frankel grade scores 13 cases were improved by one grade,8 cases by 2 grades and 4 cases by 3 grades,and 1 case was unimproved. No case was found delayed neurological disorder. Conclusion The typing of severe thoracolumbar fractures should be identified at first, and then according to different fracture types different operative strategies should be taken combined with preoperative evaluation,which has primary effect on spinal stabilization and recovery of spinal injury.