前路手术治疗胸腰段脊柱骨折54例疗效分析

ANALYSIS OF CURATIVE EFFECTS OF ANTERIOR APPROACH ON 54 CASES OF THORACIC WAIST SPINAL FRACTURES

[目的]探讨前路手术方法在胸腰段骨折中的应用和临床疗效分析。[方法]对54例严重胸腰段骨折的患者采用左侧经胸膜后、或胸腹联合切口入路椎管前方减压去除位于后纵韧带前方的致压物如骨折块及破裂后突的椎间盘组织。[结果]54例中,43例椎体近解剖复位,11例复位良好。无感染、无胸膜粘连和断钉等并发症,全部椎体间骨性融合。术后随访3～24个月,无脊髓再损伤病例,伤椎部位脊椎曲度恢复正常,无明显侧凸或后凸畸形发生;术后3个月复查植骨愈合良好,无植骨块塌陷及高度丢失现象,随访期内无植骨不愈合或钢板螺钉断裂现象。[结论]在治疗胸腰段骨折中,前路入路安全可靠,对脊髓减压彻底,有利于神经功能恢复,重建脊柱稳定性好,为患者顺利恢复创造条件。

[ Objective ] To investigate and discuss the application and curative effect of anterior approach on thoracic waist spinal fractures. [ Methods] 54 cases with severe thoracic waist spinal fractures were carried out the operation that through pleura on the left side or abdominothoracic incision, entering the front of spinal canal to undertake decompression and remove fractures pieces and palinal intervertebral disk tissue. [ Results] In 54 cases, 43 cases had proximate anatomical reductions, reduction of 11 cases was fine. There were no complications such as infection, pleura adhesion and broken nail, all vertebras were bony fusions.After operation, follow-up was proceeded 3-24 months, there were no reinjured spinal cord case, curvature of vertebral column recovered, obvious teratogenesis as side or palinal convex ; 3 months after operation, transplanted bones were rechecked. There were fine bone healing, no collapse transplanted bones and multiple loss, transplanted bones healing and no broken nails in follow-up period. [ Conclutin ] In the treatment of thoracic waist spinal fractures, anterior approach is safe and reliable. It is helpful for the recovery of nerve function, has good stability to rebuild vertebral colunm and helps patients recover favourably.