胸腰椎骨折并脊髓马尾神经损伤36例的早期治疗

Early treatment of fracture of thoracolumbar spine with spinal cord injury (36 reports)

目的 探讨胸腰椎骨折并脊髓马尾神经损伤早期经后路减压短节段椎弓根内固定效果。方法 本组36例,男28例,女8例,平均33.5岁。在X-线片上测量脊柱后凸角(Cobb’s角),在CT片上测量椎管狭窄率,脊髓神经功能按Frankel分级评定。后路内固定器械分别用Luque’s棒、Dick钉或RF钉。结果 术后随访6月～3年,平均18月。脊椎后凸角平均为10°(术前22°),椎管狭窄率平均为11％(术前62.6％),不全瘫脊髓神经功能进步1或1级以上为77.2％(27/35)。结论 胸腰椎骨折并脊髓马尾神经损伤早期经后路减压短节段椎弓根内固定可使脊髓神经功能得到有效恢复。

Objective To determine the effects of posterior decompression of spinal canal and short segmental fixation with pedicle screws. Methods There were 36 patients with thoracolumbar fracture in this series. Of these 36 cases there were 28 males and 8 females, their ages ranged from 21 to 46 years (mean 33.5 years). Cobb's angle and narrow of spinal canal was determined through X-ray and CT. Nurologic function was e- valuated according to Frankel classification. Luque, Dick and RF instrumentation were applied to the traumatic segments, respectively. Results Average follow-up time were 18 months. X-ray evaluation showed that Cobb's angel was 11 degree meanly. (preoperatively 22 degree). The narrow of canal was 11 % by CT (preoperatively 62.6%). One or more levels recovery of incomplete spinal cord injury was 77.2% (27/35). Conclu- sion The present results demonstrated nurologic function improvement correlated with decompression of spinal canal and short segmental fixation.