摘要
目的探讨胸腰椎爆裂骨折(TLBF)的手术适应证。方法回顾分析139例确诊为TLBF患者,分为两组:非手术治疗组47例,采用卧硬板床及石膏支具固定;手术治疗组92例,采用椎体钢板与椎弓根螺钉复位固定技术,脊髓神经功能按ASIA损伤分级。结果术后平均随访6年2个月,平均脊椎后突角:术前23.5°,术后8.5°;中柱后突程度:术前25%～85%(平均33%),术后0～53%(平均12%);椎体前缘高度:术前平均45%,术后恢复平均85%;椎管狭窄程度:术前30%～85%(平均55%),术后0～50%(平均20%);随访神经功能恢复到E级的手术组优于非手术组,两组统计学差异均显著(P<0.01)。结论伴有或可能出现继发性神经损害,尤其是伴有较严重后柱损伤的TLBF均不稳定,均应尽早手术。
Objective To observe the indications for early surgical trea tment of thoracolumbar burst fracture (TLBF). Methods 139 cases who had been def initely diagnosed as TLBF were analyzed retrospectively. They were divided into 2 groups: operation and non-operation. 47 patients had non-surgical treatment, such as bed-rest plaster brace. 92 patients had surgical treatment with plate and root screw. Spinal cord functions were evaluated according to the ASIA metho d. Results All patients were followed up for 6 months to 10 years (averaged 6 y ears and 2 months). Their average kyphosis angle measured with Cobb method was 2 3.5° before the operation and 8.5° after the operation. The average degree o f middle column posterior convexity was 25%～85% before the operation (averag ed 33%) and 0～53% after the operation (averaged 12%). The average height of anterior column was 45% before the operation and 85% after the operation. T he average degree of spinal stenosis was 30%～85% before the operation (avera ged 55%) and 0-50% after the operation (averaged 20%). There were more case s whose neural function recovered to grade E in the operation group than in the non-operation group (P< 0.01). Conclusion TLBF, especially combined with origi nal neural injury or secondary neural injury or severe posterior column injury, is instable and should be managed with early surgical treatment.
出处
《中华创伤骨科杂志》
CAS
CSCD
2003年第4期338-341,共4页
Chinese Journal of Orthopaedic Trauma
