前路减压Kaneda内固定治疗胸腰椎爆裂性骨折并不完全性截瘫

Anterior Decompression and Kaneda Internal Fixation of Thoracolumbar Vertebral Burst Fracture Complicated with Incomplete Paraplegia

作者报告16例胸腰椎爆裂骨折并不完全性截瘫。术前均经CT检查显示椎管内有骨块挤入。本组全部采取前路手术减压,植骨Kaneda内固定。术后经5个月～5年的随访,神经功能按Frankel分级评定,16例分别有1～3级恢复。本文同时讨论了手术方法中有关的并发症,并认为:胸腰椎爆裂骨折并不完全性截瘫脊髓压迫主要来自前方,前路减压同时植骨Kaneda内固定比后路手术更合理有效。

Sixteen cases with thoracolumbar vertebral burst fracture complicated with incomplete paraplegia were reported. Every CT image showed there were bone fragments in vertebral canal before operation. The patients were all operated on with anterior decompression and Kaneda internal fixation. After 5 months to 5 years follow- up, all the neural function were recovered Grade 1 to 3 respectively in accordance with Frankel Grade. The article also discussed the complications of the operation. The authors believe that the compression on spinal cord by the fracture was mainly from anteriority. So it was more reasonable and effective to decompress with anterior approach, to bone graft and to Kaneda internal fixation than to operate with posterior approach.