复位内固定治疗脊柱骨折脱位合并脊髓损伤

Treatment of Spinal Fracture-Dislocation with Spinal Cord Injury by Reduction and Internal Fixation

本文报告1989年3月至1990年1月外院转入我院53例脊柱骨折脱位合并脊髓损伤患者,其中50例曾行手术治疗。结果,复位:向后成角平均20.5°,37例有成角,占70％;椎体移位平均0.5cm,47例有移位,移位率88％。固定:53例中仍存有内固定者18例,有11例内固定失败,占61％。减压:27例做核磁检查,有椎管狭窄脊髓受压者19例占70.4％。我院1981～1989年对32例新鲜脊柱骨折脱位进行复位内固定术。结果,复位:完全复位24例(75％),大部复位6例(19％),部分复位2例(6％)。内固定:无改变29例,3例失败,占9％。通过对比分析,提出充分复位、减压及有效内固定的重要性。

85 cases of spinal fracture - dislocation with spinal cord injury were admitted from March 1989 to January 1990. Among them,53 cases with old injury transfered from other hospitals, 32 cases with fresh injury operated immediately in our hospital. The results of reduction of fracture-dislocation and internal fixation of two groups were compared. The authors emphasized that treatment of spinal fracture-dislocation with spinal cord injury was hyperextensive reduction,complete decompression of spinal cord and internal fixation by transpedicular screw of short segments in the early operation.