胸腰椎骨折后路手术技巧探讨
摘要
后路应用短节段椎弓根螺钉系统治疗胸腰椎骨折,恢复伤椎高度、脊柱生理弧度及间接椎管减压效果肯定。但后路手术时椎管前方的减压不是直视下操作,无法客观准确地判断,易出现椎管内骨块残留,造成减压不彻底,影响神经损伤的恢复,且伤椎复位后椎体内骨小梁支架结构并未同时恢复,形成了椎体内的空隙,是内固定物失败及椎体高度的丢失、脊柱后凸畸形导致脊髓或马尾迟发性损害及慢性腰背痛的主要原因。为减少后路手术并发症,本文对后路手术的一些技巧加以探讨,
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第9期889-890,共2页
Chinese Journal of Orthopaedic Trauma
参考文献8
-
1Bridwell KH,Dewald Rl.THe textbook of spinal surgery.2nd ed.Philadelphia:Lippincott-Raven Publishers,1997:971-979.
-
2Alanay A,Acaroglu E.Yaziei M,et al.Short-segment Pedicle instrumentation of thoracolumbar burst fractures:does transpedieular intracorporeal grafting prevent early failure?Spine,2001,26:213-217.
-
3Knop C.Fabian HF,Bastian L,et al.Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting.Spine,2001,26:88-99.
-
4王华东,侯树勋,史亚民,李利.椎弓根固定结合椎体成形术治疗胸腰椎爆裂骨折[J].中华创伤骨科杂志,2005,7(6):533-536. 被引量:23
-
5Parker JW,Lane JR,Karalkovic EE,et al.Successful short-segment instrumentation and fusion for thoracolumbar spinal fractures:a consecutive 4 1/2-year study.Spine,2000,25:1157-1170.
-
6徐宝山,唐天驷,倪才方,杨惠林,徐耀增,包肇华.后路切开复位短节段椎弓根内固定和椎体成形术治疗胸腰椎骨折[J].中华创伤杂志,2003,19(5):264-266. 被引量:29
-
7Verlann JJ,van Helden WH,Oner FC,et al.Balloon vertebroplasty with calcium phosphate cement augmentation for direct restorration of traumatic thorcolumbar vertebral fractures.Spine,2002,27:543-548.
-
8Dick W.Osteosynthesis of severe injuries of the thoracic and lumbar spine with internal fixation.Langenbeeks Arch Chir,1984,364:343-346.
二级参考文献22
-
1黄国忠,王新宇,黄波.Scofix器械内固定加椎体内植骨治疗胸腰段骨折62例分析[J].中华创伤骨科杂志,2004,6(11):1291-1292. 被引量:4
-
2Weidenbanx M, Farcy JPC. Surgical management of thoracic and lumbar burst fractures. In: Bridwell KH, Dewald RL, eds. The text book of spinal surgery. 2nd ed. Philadelphia(NY) : Lippincott - Raven Publishers,1997. 1839- 1880.
-
3McLain RF, Sparling E, Benson DR. Early failure of short- segment pedicle instrumentation for thoracolumbar fractures. A preliminary report.J Bone Joint Surg (Am), 1993, 75:162 - 167.
-
4Alanay A, Acaroglu E, Yazici M, et al. Short- segment pedicle instrumentation of thoracolumbar burst fractures: does transpedicular intracorporeal grafting prevent early failure? Spine, 2001, 26:213 -217.
-
5Knop C, Fabian HF, Bastian L, et al. Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting.Spine, 2001, 26: 88-99.
-
6Cotton A, Boutry N, Cortet B, et al. Pemutaneous vertebroplasty: state of the art. Radiographics, 1998, 18:311-320.
-
7Mermelstein LE, McLain RF, Yerby SA. Reinforcement of thoracolumbar burst fractures with calcium phosphate cement. Spine, 1998, 23:664 -670.
-
8Belkoff SM, Mathis JM, Erbe EM, et al. Biomechanical evaluation of a new bone cement for use in vertebroplasty. Spine, 20(10, 25:1061 -1064.
-
9Deramond H, Depriester C, Galibert P, et al. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications and results.Radiol Clin, 1998, 36 : 533 - 546.
-
10Cotton A, Dewatre F, Cortet B, et al. Percutaneous vertebroplasty for osteolytic metastases and mydoraa: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow- up.Radiology, 1996, 200:525-530.
共引文献50
-
1雷荣福,陈明,郑常青.经椎弓根内固定+椎体成形治疗胸腰椎骨折18例报告[J].解剖与临床,2006,11(6):395-396. 被引量:6
-
2李万年,陈建华.椎板回植悬吊融合在椎体骨折手术中应用的短期疗效观察[J].青海医药杂志,2012,42(3):24-26.
-
3刘昌文,马迅.胸腰椎爆裂骨折手术治疗的研究进展[J].实用骨科杂志,2004,10(2):144-147. 被引量:22
-
4周云,陈海啸,杨惠林,唐天驷.椎体成形术和椎体后凸成形术[J].临床骨科杂志,2005,8(5):468-471. 被引量:8
-
5王向阳,戴力扬,徐华梓,池永龙,蒋盛旦,李新锋.胸腰椎不同程度前中柱骨折内固定后的生物力学特征及前路重建的意义[J].中华创伤杂志,2006,22(3):214-217. 被引量:21
-
6周云,唐天驷,章洪喜,杨惠林,熊成东,潘高峰,刘昌胜,王以进.可吸收球囊椎体成形术治疗胸腰椎爆裂骨折的实验研究[J].中国矫形外科杂志,2006,14(16):1252-1256. 被引量:5
-
7周云,唐天驷,杨惠林,程华强,章洪喜,王根林,冯孝志.可吸收球囊椎体成形术治疗胸腰椎爆裂骨折[J].中华创伤杂志,2007,23(2):127-130. 被引量:11
-
8张绍东,吴小涛,杨惠林,唐天驷,陈辉,蒋赞利,茅祖斌,孔翔飞,王宸.椎弓根钉固定结合注射性硫酸钙椎体成形术治疗胸腰椎骨折[J].中华创伤骨科杂志,2007,9(3):225-228. 被引量:20
-
9镇万新,高国勇,王巨,刘洪涛,徐亮.微创经皮椎弓根内固定术治疗胸腰椎骨折[J].中华创伤骨科杂志,2007,9(7):638-641. 被引量:15
-
10孙新哲.椎弓根钉固定结合经椎弓根植骨治疗老年胸腰椎骨折9例[J].中国老年学杂志,2007,27(15):1523-1523. 被引量:2
-
1赵国文,李海江,温必成,霍燕昆,张凯.AF系统治疗胸腰椎爆裂骨折32例临床分析[J].实用骨科杂志,2003,9(4):343-344. 被引量:1
-
2孟书陶.合并椎管内骨块的胸腰椎爆裂性骨折后路手术疗效分析[J].求医问药(下半月刊),2011,9(10):264-264.
-
3徐跃根,杨亚东,黄志海,蒋毅,卢厚微.三椎体六枚椎弓根螺钉固定治疗胸腰椎单椎体爆裂性骨折[J].中华创伤骨科杂志,2010,12(2):190-191. 被引量:4
-
4冀明欣.跨伤椎短节段椎弓根螺钉固定附加伤椎椎弓根固定治疗胸腰椎爆裂骨折疗效观察[J].基层医学论坛,2016,20(30):4192-4193. 被引量:5
-
5滕云升,郭永明,张朝,赵玲珑,智丰,吴勐,梁高峰.椎弓根螺钉内固定加后外侧植骨融合治疗胸腰段脊柱骨折[J].美中国际创伤杂志,2006,5(4):58-58. 被引量:2
-
6徐建伟.短节段椎弓根螺钉治疗胸腰段爆裂性骨折[J].国外医学(骨科学分册),2001,22(4):247-247.
-
7李生平.AF系统内固定治疗胸腰椎骨折44例临床分析[J].广西医学,2007,29(12):1880-1882. 被引量:7
-
8陈国方,李青.椎弓根螺钉内固定系统治疗胸腰椎骨折[J].中国基层医药,2010,17(1):30-31. 被引量:11
-
9张锋,张文志,李旭,段丽群,贺瑞.后路长节段与短节段椎弓根螺钉治疗胸腰段爆裂性骨折的疗效比较[J].临床骨科杂志,2013,16(2):132-135. 被引量:14
-
10邱海滨,赵学文,刘明礼.短节段椎弓根螺钉内固定系统取出21例体会[J].中国骨与关节损伤杂志,2006,21(4):298-299.