椎旁肌入路手术治疗胸腰段爆裂骨折并不全脊髓损伤的疗效

Efficacy of the posterior paraspinal muscle approach fixation on the functional recovery of thoracolumbar burst fractures with spinal cord injury:Analysis of 25 cases

目的探讨胸腰段爆裂骨折合并神经损伤经椎旁肌入路后路内固定术与术后功能恢复的关系。方法对2007-01～2009-12收治的25例胸腰段爆裂骨折合并神经损伤手术及术后治疗进行回顾性分析。结果术后随访发现椎体高度、椎间隙宽度恢复大于90%,椎弓根钉位置良好。术后神经功能明显恢复,Frankel分级提高1～2个级别。1a随访结果表明,内固定无松动、断裂。椎体高度、椎间隙宽度丢失小于10%。结论后路经椎旁肌入路内固定术可有效治疗后方韧带结构完整的胸腰段爆裂骨折并不全神经损伤,术后患者恢复效果满意。

Objective To explore the relationship between the postoperative neurological functional recovery and posterior paraspinal muscle approach fixation in patients with thoracolumbar burst fractures.Methods From January 2008 to December 2010,25 patients with thoracolumbar burst fracture combined nerve injury surgery were treated by posterior paraspinal muscle approach fixation,postoperative data were analyzed retrospectively.Results The postoperative follow-up found that the vertebral height,disc space width recovery greater than 90%,and pedicle screw in good position.Nerve function was restored after 1~2 Frankel grade level.One year follow-up results showed that internal fixation without loosening and fracture.Vertebral height and disc space width loss were less than 10%.Conclusion The posterior paraspinal muscle approach fixation can effectively therapy integrity of the posterior ligament of thoracolumbar burst fracture with incomplete nerve injury,postoperative recovery of patients is satisfactory.