后入路手术治疗胸腰段爆裂性骨折

Posterior surgery for thoracolumbar burst fracture

目的分析后入路手术治疗胸腰段爆裂性骨折的疗效及适应证。方法应用后入路手术治疗胸腰段爆裂性骨折38例。从影像学、手术操作过程及神经功能恢复等方面分析疗效。结果伤椎高度由47·3%恢复到94·4%;水平移位完全恢复;Cobb角由术前22·6°恢复到术后3·6°。椎管受压程度:删除椎管开放减压的7例,余受压面积由术前42%恢复到术后16%,受压的矢状径从术前54·9%恢复到81·8%。脊髓神经功能恢复依照Frankel分级标准均有1级以上改善。结论合理选择后入路手术对胸腰段爆裂性骨折治疗效果良好,手术中进行椎管造影有助于提高复位效果。

Objective To investigate the effect and indication of posterior surgery for thoracolumbar burst fracture. Methods 38 cases with thoracolumbar burst fractures treated with posterior surgery were enrolled. The effect was studied by images, operation process and neural function recovery. Results The height of injured vertebrae was recovered from 47.3% to 94.4%. Translational displacement was completely restored. Cobb angle was from 22.6° to 3.6°. The compression area was from 42% to 16% except for the laminectomy 7 cases. The sagittal diameter was from 54.9% to 81.8%. The spinal cord function recovery was over 1 grade. Conclusions Reasonable election of posterior surgery for thoracolumbar burst frature can provide good effect, and intraoperative myelography can enhance reduction.