摘要
目的 探讨胸椎、上腰椎前路手术应用胸腔镜技术的可行性。 方法 5例胸、腰椎结核 (T6～L2 )行胸腔镜下结核病灶清除、植骨或非植骨术 ;3例椎体爆裂性骨折合并截瘫 (T10 ～T12 )及 1例陈旧性椎体爆裂骨折合并马尾综合征 (L1)行胸腔镜下脊髓减压、植骨、钢板螺丝钉内固定术 ;1例T3～ 4椎间盘突出伴脊髓压迫症行胸腔镜下减压融合术。 结果 全部病例切口Ⅰ期愈合 ,CT或MRI显示病灶清除彻底 ,脊髓充分减压 ,除 1例骨折复位、固定后仍有轻度成角畸形外 ,均复位满意 ,内固定可靠 ,位置良好。 结论 胸椎、上腰椎疾患 ,不论是否并发脊髓、马尾神经压迫 ,都适宜在胸腔镜辅助下进行病灶清除术 ,必要时还可进行脊髓减压、脊柱前路植骨。
Objective To discuss the feasibility of application of anterior approach video-assisted thoracoscopic surgery (VATS) in thoracic and upper lumbar spine. Methods In the study there were: 5 patients with tuberculosis of thoracic or lumbar spine (T 6 ～ L 2) undergoing thoracoscopic cleaning of focus,with or without bone grafting; 3 patients with vertebral burst fracture ( T 10 ～ T 12 ) and 1 patient with old burst fracture (L 1) accompanied with cauda equina syndrome undergoing thoracoscopic decompression,bone grafting and plate screw internal fixation; 1 patient with intervertebral disc protrusion (T 3 ～ 4 ) accompanied with spinal compression receiving thoracoscopic decompression and spondylodesis. Results The incisions in all the patients healed by first intention.CT or MRI examinations revealed that: the foci had been cleaned thoroughly and the spinal cords had been decompressed completely; the reduction was satisfactory,except for 1 patient with slight angulation deformity; the internal fixation was stable,with proper position. Conclusions VATS focus cleaning is suitable for patients with diseases in thoracic or upper lumbar spine,regardless of whether there is compression of spinal cord or cauda equine or not,and,if necessary,spinal decompression,anterior bone grafting,or internal fixation may be conducted simultaneously.
出处
《中国微创外科杂志》
CSCD
2004年第4期307-308,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
胸腔镜
脊柱结核
脊柱损伤
前路手术
内固定
Thoracoscopy
Spinal tuberculosis
Spinal injury
Anterior approach surgery
Internal fixation
