摘要
目的:通过回顾性分析186例胸腰段爆裂骨折伴脊髓损伤急性期病例的治疗结果,探讨前后路手术及长短节段脊柱 复位器的适应证的选择。方法:60例经前路减压植骨,采用Z-plate钢板等内固定,126例后路手术,其中30例采用Harrington 长节段复位固定,96例采用短节段椎弓根钉内固定。结果:随访6个月-36个月,平均14个月。短节段固定复住效果明显优 于长节段。合理选择手术方式,疗效满意,固定可靠,无断棒断钉等并发症。结论:胸腰段爆裂骨折宜选用短节段椎弓根钉系 统内固定。对于急性损伤,胸11、12椎骨折,若椎管管径受累未达20％,且后纵韧带较完好时,宜选用后路手术;若椎管管径 受累超过20％,且后纵韧带断裂时,应选择前路手术;腰1、2椎骨折,当椎管受累达50％以上,选择前路手术。反之,椎管 管径受累小于50％时,选择后路手术。
Objective: To analyze the application of anterior or posterior decompression and internal fixation (including long or short segment device) for thoraco-lumbar burst fractures by retrospectively 186 cases of thoraco-lumbar burst fractures. Methods: Sixty cases of thoraco-lumbar burst fractures were treated by anterior decompression and internal fixation. (Z-plate device), 126 cases of thoraco-lumbar burst fractures were treated by posterior decompression and internal fixation (30 cases with Harrington long segment device, 96 cases with short segment device) . Results: One hundred and eighty-six cases were followed up from 6-36 months (average 14 months), and the results of treatment were clinically satisfactory. There were no complication related to the internal fixation .Short segment device were better than long segment device. Conclusion: Short segment devices should be selected for BF of thoraco-lumbar. To BF of T11·12, when the diameter of spinal<20%,and the posterior longitudinal ligament(pll) should be in good condition , posterior decompression and internal fixation could be applicated. While the diameter of spinal>20%,or the pll was destroyed, anterior decompression and internal fixation was better for thoraco-lumbar burst fractures. To L1、2, when the diameter of spinal>50%, anterior decompression and internal fixation should be the first choice. While the diameter of spinal<50%, posterior decompression and internal fixation could be applicated.
出处
《伤残医学杂志》
2005年第1期9-11,共3页
Medical Journal of Trauma and Disability
关键词
内固定
长短节段
治疗
胸腰段爆裂骨折
脊髓损伤
Burst fracture
Posterior
Anterior
Internal fixation
Long segment
Short segment
