胸腰椎骨折前路内固定研究进展

Advanced progress on the treatment of anterior approach to the thoracolumbar vertebral fractures

胸腰椎骨折是常见而较为严重的创伤,前路手术可直视下保证椎管得到彻底减压,同时前柱承载着脊柱主要的载荷分布,而前路手术能实现前柱的骨性融合并重建脊柱前柱的高度,故前路手术仍是胸腰椎骨折治疗中的重要方法。随着脊柱钉棒系统的应用,临床上大多采用后路开放手术治疗,但前路内固定因具有独到的优势,单纯后路并非能取代。本文综述总结前路手术治疗胸腰椎骨折的生物力学特点、手术适应证选择、前路内固定器械、植骨方法及技术要点,以期为临床治疗胸腰椎骨折提供更佳确切的证据。

Thoracolumbar fractures are common and severe traumas. Anterior approaches can achieve adirect spinal cord decompression and reconstruct anterior column height what load bearing the major load distribution of the spine. Therefore,anterior approach is an important method in the treatment of thoracolumbar fractures. With the application of pedicle screw,most of the patients were treated with posterior approaches.Because of the unique advantages of anterior approach,the posterior approach can not be replaced it.The review summarizes the biomechanical characteristics 、indications、fixation devices、bone grafting method and technique of the anterior approach and in order to provide better evidence for clinical treatment of thoracolumbar fractures.