胸腰椎Chance骨折和屈曲过伸型损伤的手术治疗

Surgical Management for Chance and Flexion Distraction Injuries to the Thoracolumbar Spine

目的 :观察胸腰段Chance骨折和屈曲过伸型损伤伴神经损伤的手术疗效。方法 :全组 11例 ,男 8例 ,女 3例 ,年龄 15～ 48岁 ,平均 34岁。神经功能FrankelA级 2例 ,B级 2例 ,C级 2例 ,D级 4例和E级 1例。手术内固定器械分别使用了Harrington、沈氏、RF和CD内固定系统。随访时间 1～ 9年 ,平均 3年 8个月。结果 :全组病例脊柱后柱分离得到明显恢复 ,脊柱前柱压缩亦得到改善。除 2例FrankelA级患者神经功能无变化外 ,8例不全截瘫均有Frankel 1级以上的改善。结论 :手术治疗可及时恢复脊柱的稳定性 。

Objective: A retrospective study was carried out to observe surgical treatment for Chance and flexion distraction injuries to the thoracolumbar spine.Methods:11 cases with thoracolumbar Chance and flexion distraction injuries were included in this series.Of these 11 cases there were 8 males and 3 females,their ages ranged from 15 to 48 years(the mean were 34 years).Based on Denis classification:there were 5 patients suffered from type A flexion distraction injuries(Chance injuries),2 suffered from type B injuries,4 suffered from type C injuries.According to Frankel classification:there were 2 patients with grade A,B,C,respectively.4 patients had grade D and the remaining one had grade E.Posterior instrumentation were applied to the traumatic segments.Results:Distraction deformity of posterior element were reduced significant in all patients,meanwhile,compression of anterior column was restored.Neurologic function improvement of more than one Frankel grade were in all incomplete paraplagia patients.Conclusion:The present study demonstrated surgical treatment and internal fixation were suitable for stabilization of flexion distraction injuries and neurologic recovery.