无神经功能障碍的胸腰椎爆裂型骨折的治疗

Treatment of the Non-nerve Dysfunction Thoracolumbar Burst Fracture

目的探讨无神经功能障碍的胸腰椎爆裂型骨折的治疗方法及效果。方法对23例无神经功能障碍的胸腰椎爆裂型骨折的病人在椎弓根钉复位固定的同时,经椎弓根向伤椎体内植骨,双开窗探查减压,横突或关节突间植骨治疗。结果所有患者均获随访,时间6个月～3年,平均2.2年。术后X线示椎体恢复高度及生理弧度,无后凸畸形,植骨融合好,无神经功能障碍,长期随访无明显椎体再压缩。结论治疗无神经功能障碍的胸腰椎爆裂型骨折时,双开窗较以往全或半椎板切除更安全,既达到探查减压目的又有效保留后柱稳定性,效果满意,值得临床应用。

Objective To investigate the treatment and effect of the non-nerve dysfunction thoracolumbar burst fracture. Methods 23 cases of non-nerve dysfunction thoracolumbar burst fracture patients, with the pedicle screw fixation at the same time, from pedicle bone graft to the injured vertebra, double windows exploration decompression. The treatment of bone graft between transverse process or articular process. Results All of the patients were followed up from 6 months to 3 years, an average of 2.2 years. After surgery, the X-ray showed that vertebral body restorted its height and curvature, no kyphosis,good fusion, and no neurological deficit, long-term follow-up showed there was no significant re-vertebral compression. Conclusion When therapy the thoracic-lumbar vertebrae blowout-type of no nerve function disorde, double windowing is more safer than removal of hol-vertebral plate or sem-vertebral plate. By this method, not only can decompress when explore, but also retain the stability of dorsicolumn. The therapeutic effect is satifactory and it deserves clinical application.