后路全脊椎切除治疗胸腰椎陈旧性骨折角状后凸畸形的疗效观察

Effects of posterior vertebral column resection in treating old fracture of thoracolumbar spine with severe angular kyphosis

目的探讨后路全脊椎切除治疗胸腰椎陈旧性骨折角状后凸畸形的手术方法及临床疗效。方法 15例胸腰椎陈旧性骨折角状后凸畸形患者采用后路全脊椎切除术,术后随访6～36个月,观察其临床症状缓解、手术前后后凸Cobb角度变化及Frankel分级情况。结果术后患者临床症状均得到明显缓解,术前后凸Cobb角为(51.2±4.9)度,术后经随访恢复为(11.2±1.7)度,术后后凸Cobb角度<术前(P<0.01),且术后Frankel分级明显降低。结论后路全脊椎切除结合椎弓根内固定与椎板减压治疗胸腰椎陈旧性骨折角状后凸畸形效果显著。

Objective To investigate the operation method and clinical curative effects of the posterior total vertebral resection in the treatment of old thoracolumbar fractures angular kyphosis deformity. Methods Fifteen patients with old thoracolumbar fractures angular kyphosis deformity received the posterior total vertebral resection. The postoperative follow-up lasted for 6-36 months. Clinical symptomatic relief, onvex Cobb angle and Frankel classification of the patients were observed. Results Patients＇clinical symptoms af- ter operation got obviously relieved. Postoperative kyphosis angle Cobb（ 11.2 ± 1.7 ）was lower than that of the patients before treatment （ 51.2 ± 4.9） （ P 〈 0.01 ） and Frankel grading was significantly reduced. Conclusion Posterior total vertebral resection combined with pedicle screw internal fixation and posterior decompression in treating thoracolumbar angular old fracture kyphosis has obvious cur-ative effects.