前后路手术治疗胸腰椎陈旧性骨折

Surgical treatment of obsolete thoracolumbar vertebral fractures by anterior or posterior approach

目的探讨前后路手术在陈旧性胸腰椎骨折治疗中的应用价值。方法对56例陈旧性胸腰椎骨折经前路或后路行椎管扩大减压植骨、内固定术。结果所有患者随访6个月-5年,平均19个月。56例术后症状明显缓解,受压脊髓得到有效减压,植骨融合率高,前路手术脊髓神经功能改善优于后路后术,并发症少。结论椎管侧前路减压对陈旧性胸腰椎骨折的治疗有效,后路后术适用于单纯脊柱失稳者。

Objective To investigate the clinical values of anterior and posterior surgical treatments of obsolete thoracolumbar vertebral fractures.Methods 56 cases of obsolete thoracolumbar vertebral fracture were treated with canal amplification,decompression,internal fixation and bone grafting by anterior or posterior approach.Results They were followed up from 6 months to 5 years(averaging 19 months)postoperatively.The symptoms of the 56 cases were relieved obviously.The compressed spine cords were decompressed effectively.The rate of fusion of the implanted bone was high.The anterior approach resulted in better functional recovery and fewer complications than the posterior approach.Conclusion The anterior decompression of the vertebral canal is effective for the obsolete thoracolumbar vertebral fractures,while the posterior approach for the patients simply with unstable spine.