半椎板切除椎管成形治疗胸腰椎爆裂骨折

Semi-laminectomy spinal canal reconstruction in treatment of burst thoracolumbar fractures

目的探讨胸腰椎爆裂性骨折新的手术方式。方法根据骨折类型不同，采用后入路半椎板切除椎管成形GSS钉棒系统内固定治疗胸腰椎爆裂性骨折47例。结果47例平均随访32．6个月，术前Cobb’s角平均30°，术后平均9°。38例术后脊髓损伤获得Frankel分级1～3级以上的改善。结论后入路半椎板切除椎管成形GSS钉棒系统内固定治疗胸腰椎骨折具有损伤小、出血少、操作简单、减压彻底、固定可靠等诸多优点，可作为治疗胸腰椎爆裂性骨折的理想术式。

Objective To explore a new operative method for thoracolumbar burst fractures（TLBF）. Methods Forty-seven patients with TLBF received posterior improved semi-laminectomy spinal canal decompression and GSS internal fixation. Results All were followed up for an average of 32.6 months. The pre-operafive average Cobb＇ s angle was 30°, and the post-operative av- erage angle was 9°. Based on Frankel＇s grading, nervous function improved by grade one to three in 38 patients. Conclusion This method has advantages of less injury, less bleeding, simple manipulation, thorough decompression and reliable fixation. It can return the volume of the spinal canal to normal, reconstruct spinal stability and improve spinal cord or nerve function.