胸腰椎陈旧性骨折的术式选择

Treatment of Old Thoracolumbar Fractures

【目的】评估陈旧性胸腰椎骨折三种术式的治疗效果。【方法】总结和回顾自1998年到2005年诊治的30例陈旧性胸腰椎骨折病人,前路手术者16例,后路手术者8例,前后路联合手术者6例。针对不同术式及其临床结果对其手术适应证及并发症进行比较分析。【结果】三种术式都有比较理想的临床结果,除一例术中出现下腔静脉破裂外,无其他严重术中并发症,术后及随访结果显示除一例全瘫病人无任何恢复外所有病例都有不同程度的神经功能恢复及症状缓解,三种术式之间比较无明显差异。【结论】陈旧性骨折的处理棘手且存在争议,仔细评估患者术前情况,选择合适的术式,可以获得安全有效的临床结果。

【Objective】To investigate the operative indication of old thoracolumbar fractures.【Methods】Three approaches were used for 30 cases of the old thoracolumbar fractures according to its situation since 1998 to 2005.In these cases,anterior procedure was performed in 16 cases,posterior procedure in 8 cases,combined anterior and posterior procedure in 6 cases.The clinical outcomes of these approaches were compared.【Results】No severe complication occurred in these three approaches.Local ache alleviated remarkably after operation and during the follow-up period.The neurological deficits were improved.【Conclusion】Reasonable selection of surgical procudure according to careful consideration of the old thoracolumbar fractures patient＇s situation before operation can achieve an efficient and safe clinical outcome.