胸腰段骨折脱位手术复位术后随访评价

Follow-up evaluation of curative effect after surgical reduction for thoracolumbar vertebral fracture dislocation

目的 对胸腰段骨折脱位不同手术方法复位结果进行评价。方法 随访我院15年来收治胸腰段骨折脱位并脊髓损伤病人中残留不同程度骨折脱位、复位不完全32例作为病例组,将现行体位复位结合器械矫正并发生同样变化的31例作为对照组,对两组病例的术前、术后及随访结果X线片中椎体高度、脱位整复、后弓角矫正几方面进行比较分析。结果 对照组的椎体高度丢失术后4周内占病例组的45％;6个月以上为27％。脱位位移术后4周对照组占病例组的5.7％;6个月以上不足1％。对照组后弓角术后4周内占病例组的7％以下;6个月以上为11％以下。结论 体位复位结合器械矫正手术方法可提高胸腰段骨折脱位完全复位率,确实可靠植骨融合是防治晚期再脱位的有效措施。

Objective To evaluate the curative effect of different reduction methods for thoracoiumbar vertebral fracture dislocation Methods 216 patients of thoracoiumbar vertebral fracture and spinal cord injury uncountered in this hospital during the last 15 years were followed up. Of them,32 cases remained fracture dislocation and incomplete reduction as case-study group;31 cases with the same symptoms were operated upon using the postural combined with instrumental reductions as control group. Situation of preoperative and postoperative, the recovery of vertebral height and the rectifying of arch angle after reduction as shown in the X-ray films were analyzed. Results The rate of loss of height of the vertebral body in the control group with vertebral height was 45 % of the case-study group 4 weeks after the operation, and after 6 months the rate was 27% . The rate of control group with fracture-location in the present surgical reduction in 4 weeks was 5.7% of the case study group, and after 6 months the rate was less than 1 % . The rate of control group with the angle rectifying in the present surgical reduction in 4 weeks was 7% of the case study group, and after 6 months the rate was lower than 11%. Conclusion Postural combined with instrumental reduction is able to improve the complete reduction rate of thoracoiumbar vertebral fracture, fusion of bone assuredly is the effective measures to prevent late redislocation.