前后联合入路行侧卧位椎弓根钉植入在脊柱外科手术中的应用可行性

The Feasibility Analysis of the Anteroposterior Approach with Patient Lying in the Lateral Position with the Pedicle Screw Implantation in the Spine Surgery

目的：探究前后联合入路行侧卧位椎弓根钉植入在脊柱外科手术中的临床应用效果以及可行性。方法：选取本院收治的30例严重胸腰椎爆裂骨折患者,采用前后联合入路行侧卧位椎弓根钉植入手术。比较患者手术前后各项指标的变化情况。结果：对患者定期随访12~24个月。手术前影像学检查发现,患者椎管容积占位率平均为（48.15±5.21）%,Cobb角平均（34.3±2.8）°,伤椎前缘高度（56.16±11.67）%,在术后及最后一次随访各项指标均恢复到满意效果,椎管内占位骨块基本全部切除,Cobb角平均恢复（3.4±1.1）°,伤椎前缘高度在手术后立即检测时升高,但最后一次随访时有所下降;在ASIA分级变化情况方面,只有1例分级为A级的患者神经功能没有恢复,其余患者神经功能均恢复了1~2级。结论：前后联合入路行侧卧位椎弓根钉植入在治疗严重胸腰椎爆裂骨折方面可以获得满意效果,值得临床推广。

Objective：To explore the clinical effect and feasibility analysis of the anteroposterior approach with the patient lying in the lateral position with the pedicle screw implantation in the spine surgery.Method：30 cases were chosen,approached with the patients lying in the lateral position with the pedicle screw implantation.Patients were regularly followed up and visited.The changes of every indicator of patients＇ bodies were compared.Result：All cases were followed up for 12 to 24 months.The average spinal canal occupation ratio was（48.15±5.21）% and the average segental Cobb angle was（34.3±2.8）°,the average anterior vertebral height was（56.16±11.67）%.But in the last time follow-up after surgery,the indicators which were examined were restored and achieved to a satisfactory results.After resection of the vertebral body,the average segmental Cobbangle was（3.4±1.1）° post-operatively,and neurology function was restored 1-2 grades in 29 cases except 1 case was not restored defined by ASIA criteria.Conclusion：Treatment of thoracolumbar burst fracture by ananteroposterior approach with the patient lying in the lateral position can result in good clinical effectiveness and it is worth promoting in the clinic.