前路减压植骨内固定治疗胸腰椎爆裂骨折

Anterior decompression and internal fixation of thoracolumbar burst fracture

目的探讨胸腰椎爆裂骨折前路手术方法和临床疗效。方法回顾评价40例胸腰椎爆裂骨折并截瘫病例经前路减压内固定手术治疗的临床资料。结果手术时间3～6h,平均4.5h;出血800～2 000ml,平均1200ml;随访2年以上,植骨均成活,平均3.5个月融合。无内固定松脱及断裂,脊髓损伤的恢复按Franke1分级:D级6例,E级34例,均恢复2级以上。无死亡病例。结论前路手术治疗胸腰椎爆裂骨折具有减压彻底、重建脊柱稳定性好、植骨融合率高、脊髓神经功能改善率高等优点,是治疗胸腰椎爆裂骨折的有效方法。

Objective To evaluate anterior thoracolumbar burst fracture surgical methods and clinical efficacy.Methods Retrospective evaluation of 40 cases of thoracolumbar burst fracture and paraplegia cases of anterior decompression and internal fixation of the clinical data.Results The operative time of 3 to 6 hours,an average of 4.5 hours;bleeding 800 ～ 2000ml,an average of 1200ml;follow-up of more than 2 years,graft all survived an average of 3.5 months of integration.Loosening and fracture without internal fixation,spinal cord injury recovery by Franke1 grade： D 6 cases,E-class,34 patients were restored to two or more.No deaths.Conclusions Anterior treatment of thoracolumbar burst fractures with complete decompression,reconstruction of spinal stability,fusion rate,high rate of spinal cord function improved,etc.,is the treatment of thoracolumbar burst fractures and effective way.