后路选择性椎管减压在胸腰椎爆裂性骨折的应用

Selective posterior vertebral canal decompression for treatment of thoracolumbar burst fractures

目的观察选择性椎管减压内固定对合并有神经损伤的胸腰椎爆裂骨折的治疗效果。方法经椎弓根钉钉棒系统内固定治疗胸腰椎爆裂骨折患者62例,对其中伴有脊髓神经损伤的49例从后路做选择性椎管减压。结果伤椎前、后缘高度分别从术前平均47·5%和76·2%恢复到正常的95·1%和98·5%,Cobbs角由术前23·34°恢复到术后的4·88°。CT示椎管截面积术前为45·2%,术后为88·7%。各项指标与术前比较差异有显著性(P<0·01),患者术后神经功能获得改善。结论后路选择性椎管减压技术对爆裂骨折的复位和椎管减压的作用是确切有效的。

Objective To evaluate the efficacy of selective posterior vertebral canal decompression for treatment of thoracolumbar burst fractures with neurological injuries. Methods 62 cases of thoracolumbar burst fractures were treated with pedicle screw internal fixation, of which 49 cases associated with neurological injuries were simultaneously undergone selective posterior vertebral canal decompression. Results The average anterior and posterior heights of fractured vertebrae were restored from 47.5% ,76. 2% preoperatively, to 95. 1% ,98. 5% postoperatively; Cobbs an- gle was restored from 23. 34°preoperatively, to 4. 88°postoperatively. There was significant deference in targets between pre-operation and post-operation （P 〈 0. 01 ）. The nerve function of most patients acquired an improvement compared with pre-operation. Conclusions Selective posterior vertebral canal decompression is effective for thoracolumbar burst fractures.