前入路减压内固定治疗胸腰椎爆裂型骨折

Anterior approch decompression and internal fixation in the treatment of thoracolumbar burst fractures

目的 评价前路减压植骨内固定治疗胸腰椎爆裂型骨折的效果。方法 对 2 0例胸腰椎爆裂型骨折患者行前路减压 ,切除椎体后缘骨块 ,解除对硬膜的压迫 ,上下椎体植骨融合内固定。结果 随访 4～ 30个月 ,平均 6个月 ,神经功能均有 1级以上的恢复。植骨块全部融合 ,椎管容量扩大 ,无骨片残留。结论 该术式疗效肯定 ,但要严格掌握手术适应证及熟练的操作技术。

Objective To observe the efficacy of anterior decompression with bone graft and internal fixation in the treatment of thoracolumbar burst fracture. Methods 20 cases with thoracolumbar burst fracture received anterior decompression, bone graft and internal fixation by resecting the fracture fragment of posterior vertebrae to relieve the oppression of dura. Results All cases were followed up for an average of 6 months(4～30 months). The nerve function recovered well, with 18 cases had nerve function improved by one grade or more according to Frankel grading. The rate of satisfaction was 90%. All the bone grafts were union and the vertabral canal were enlarged without bone remaining. Conclusion The efficacy of this operation is confirmative if the operator chould select the indications strictly and have skilled technique.