胸腰段椎体骨折并截瘫前后路手术临床分析

Clinical analysis of anterior and posterior approaches for thoracolumbar fracture with paraplegia

目的胸腰段椎体骨折并截瘫应用前后路手术治疗临床总结分析。方法采用侧前方减压加植骨融合、椎体钉固定术;后路减压DICK钉或AF钉固定术,治疗胸腰段椎体骨折并截瘫。结果对27例胸腰段椎体骨折并截瘫患者实施手术,术后平均随访1.5年。后凸成角术前平均26°,术后10°;26例获得Frankel1～3级以上的恢复。结论对于胸腰段椎体骨折合并截瘫患者应合理选择手术方法,均可获得满意的疗效。

Objective To educidate the operative techniques and treatment results of anterior and posterior decompressions for thoracolumbar fracture with paraplegia. Methods 27 cases of thoracolumbar fracture with paraplegia were operated on by anterior decompression plus bone graft with short segmental fixation with pedicle screws, or by posterior decompression with DICK fixation or AF fixation. Results Average follow up time was 1.5 years. The deformities were corrected satisfactorily, with mean degree of Cobbs angle being 26°preoperatively and 10°postoperatively. 26 patients had nervous function improved by more than one to three grades according to Frankel's grading. Conclusion Suitable operative approach should be selected according to different kinds of thoracolumbar fracture with paraplegia so as to achieve satisfactory treatment outcome.