后路侧前方减压短节段固定治疗胸腰椎爆裂骨折

Observations on the Effects of Posterior Lateral-anterior Decompression and Short-segment Stabilization in the Treatment of Thoracolumbar Vertebral Burst Fracture

目的探讨后路侧前方减压短节段固定治疗胸腰椎爆裂骨折的临床疗效。方法 12例腰椎爆裂骨折患者,经后路单侧行椎体次全切除、脊髓减压、椎弓根钉内固定。复查X线及CT片,评估骨折复位、减压及骨融合情况。结果术后获得随访6～24个月,平均12.5个月。X线片和CT显示植骨完全融合。骨折椎椎体高度由术前压缩至平均33.7%恢复至术后平均89.0%;节段性椎体后凸畸形角度由术前平均后凸20.3°,矫正至术后平均8.8°;椎管容积由术前的平均压迫51.4%恢复至术后椎管压迫完全解除。结论后路侧前方减压椎体重建短节段固定治疗重度胸腰椎爆裂骨折具有创伤小、安全性高、减压彻底等优点,疗效满意。

Objective To investigate the effects of posterior lateral-anterior decompression and short-segment stabilization in the treatment of thoraeolumbar vertebral burst fracture.Methods 12 patients with thoracolumbar burst fractures were treated with unilateral subtotal vertebraectomy through only the posterior approach,decompression,titanium rete supporting bone autograft to reconstruct the anterior and middle column,pedicles screws stabilization.Results Fractures of vertebral compression height from preoperative to postoperative average of 33.7% recovered to an average of 89.0%;segmental vertebral kyphosis from preoperative average kyphosis angle 20.3o,corrected to a postoperative average of 8.8o;spinal canal volume pressure from preoperative average of 51.4% after recovery from spinal compression completely removed.Conclusion The operation of reconstruction and short-segment stabilization by anterolateral decompression of posterior for the treatment of severe thoracolumbar burst fractures has the advantages of less injury,high safety,thorough spinal cord decompression,prompt post-operative three-column stability of spine,and satisfactory clinical effects.