胸腰段脊柱脊髓损伤手术治疗分析

Operation of thoracolumbar fracture and spinal cord injury

目的 :总结手术治疗胸腰段脊柱脊髓损伤的经验。方法 :1997年～ 2 0 0 0年手术治疗并随访胸腰段脊柱脊髓损伤 98例 ,参照 Denis分类 :单纯屈曲型 2 0例 ,爆裂型 2 6例 ,骨折脱位 52例。神经功能 Frankel分级 :A级 51例 ,B级 19例 ,C级 2 5例 ,D级 3例。分别行单纯椎板减压加内固定和环形减压加内固定。结果 :98例均手术并获随访。环形减压加内固定组 :39例术前 A级 ,术后和随访终末时仍为 A级无恢复 ,2 5例术前 C级中 2例术后仍为 C级 ,2 3例恢复至 D级。椎板减压加内固定组 :术前 A级 12例 ,术后及随访时仍为 A级 ,术前 B级 15例 ,随访时恢复至 C级 12例 ,B级 3例。 3例术前 D级 ,术后恢复至 E级。结论

Objective:To analyse the result of operation in thoracolumbar fracture and spinal cord injury.Methods:From 1997 to 2000,98 cases of thoracolumbar fracture and spinal cord injury were operated and followed up.according to Denis classification system,flexion in 20 cases,burst fracture in 26 cases,fracture and dislocation in 52 cases.Neurological function was evaluated with Frankel standard.Of them,grade A in 51 cases,grade B in 19 cases,grade C in 25 cases,grade D in 3 cases.All cases were carried with laminectomy and internal fixation or cycle decompression and internal fixation.Result:All cases were followed up.In cycle decompression group,39 cases classified to grade A before operation were still grade A at the end of follow up.However 23 of 25 cases classified to grade C before operation recovered to grade D.In laminectomy group,12 of 15 cases in grade B before operation recovered to grade C while 3 cases to grade D when they were followed up.3 cases of grade D recovered to grade E.Conclusion:Thoracolumbar fracture and spinal cord injury should be operated early.