胸腰脊椎脊髓损伤前后路手术适应症选择的思考

TREATMENT OF THORACOLUMBAR FRACTURE AND DISSCUSSION ON ITS SURGERY APPROACH

目的:通过67例胸腰脊柱脊髓损伤病例的治疗,探讨前、后路手术适应征选择的问题。方法:21例前路,采用Z-Plate等内固定,46例后路,采用短节段椎弓根钉内固定。结果:两组均获得了满意的疗效。结论:选择前或后路手术,应综合考虑脊髓损伤程度、手术时机与技巧、骨折的部位、骨折类型和影像结果等,才能确实做到减压、回复脊柱序列和坚强的固定的目的。

Objective: To discuss the controvertial problem about the selection of surgery approach in treatment of thoracolumbar fractures, whether anterior or posterior 67 cases were involved. Metheds:21 cases were treated through anterior approach by Z-Plate, etc. 46 cases through posterior appoach by pedicle screws of short-segment technique. Results:excellent curative effect had been obtained in two groups.Conclusion:To determine whether anterior or posterior appoach in treatment of thoracolumbar fractures, synthesized factors of the degree of spinal cord injure,the time after injure, surgery technique、the position、the kind of fractures and image results should be considered.