胸腰段爆裂型脊柱骨折前路手术治疗策略

Treatment Strategies on Front Part Operation on Cracked Bone Fraction around Chest and Waist

目的:探讨胸腰段爆裂性脊柱骨折前路手术的适应证、技术要点与临床效果。方法:2002年1月～2009年5月对56例胸腰椎爆裂性骨折患者行胸膜外-腹膜后前路减压与重建手术。结果:所有病例术后均获得4～86个月随访,平均38.5个月,无感染与断钉等并发症,全部椎体间骨性融合。神经功能恢复,除3例A级及10例E级无变化外,B、C、D级中的部分病例脊髓神经功能有1～3级的恢复。结论:前路减压与重建手术可解除脊髓的压迫、改善脊髓神经功能、恢复脊柱的序列及重建脊柱的稳定性。

Objectives： to explore the indication,technical points and clinical effects of front part operation on cracked bone fraction around breast and waist. Methods：from January of 2000 to May of 2007,56 patients who suffer from cracked bone fraction around chest and waist are received the oper ation through reducing the pressure and rebuilding outside pleura and back of peritoneum. Results ： all patients get regular visits for 4 -86 months and the average time is 38.5 months. No complication, such as infection, split nail, etc. is found. All bones among vertebras are completely healed. As to the recovering of nerve function, it is found that some patients spinal cord nerve functions get 1 - 3 rank recovering in B, C, D level except that 3 cases in A - level and 10 in E - level have no change. Conclusion： front part operation of reducing pressure and rebuilding can relieve spinal cord constriction,improve spinal cord nerve function, recover spinal column order and rebuild spinal column stability.