摘要
目的探讨经前路椎体切除减压固定植骨融合治疗胸腰椎骨折合并脊髓损伤的疗效。方法通过对自1985年1月至2002年6月采用前路减压固定植骨融合治疗537例胸腰椎骨折合并脊髓损伤患者临床资料分析,以及248例患者的随访结果比较,观察其神经功能恢复和局部脊柱的稳定性。结果573例患者术后均无神经功能损害加重。出院时神经功能改善情况:93例无神经损伤者,术后功能良好;新鲜骨折合并不全瘫患者275例中,240例有1～3级恢复;107例陈旧性骨折患者术后神经功能均有不同程度改善;62例全瘫患者,仅5例感觉有部分恢复。248例随访中,26例全瘫患者仅4例部分浅感觉恢复,204例不全瘫患者均有不同程度的神经功能改善。全部患者X线片显示植骨均已融合,有4例出现断钉,但无临床症状。结论对来自椎管前方压迫的胸腰椎骨折合并脊髓损伤,前路减压手术具有减压彻底、神经功能改善率高、Ⅰ期固定融合成功率高、脊柱稳定性好等优点,是治疗胸腰椎骨折合并脊髓损伤的有效方法。
Objective To investigate the curative effect of anterior decompression, internal fixation and fusion in treatment of thoracolumbar fractures combined with spinal cord injuries. Methods Data of 537 cases with thoraeolumbar fractures combined with spinal cord injuries treated with anterior decompression, internal fixation and fusion from January 1985 to June 2002 were retrospectively analyzed and compared with the follow up result of 248 cases to observe paraplegia degree, functional recovery and spinal stability. Results No aggravation of nerve injury appeared in 537 cases. At discharge, the nerve function was excellent in 93 cases without spinal cord injury, got 1-3 grade recovery in 240 cases out of 275 cases with fresh fractures combined with incomplete paraplegia, improved at various degrees in 107 cases with old fractures. But of 62 cases with complete paraplegia, only five cases obtained mild neurological recovery. The results of follow up for 248 cases showed that, out of 26 cases with complete paralysis, there were only four cases with superficial sensory recovery and 204 cases with incomplete paralysis all got nerve function recovery at diffident extents. X-ray manifested goos fusion in all eases, of which, four cases were found with broken nails but without clinical symptomes. Conclusions The anterior decompression is an effective way for thoracolumbar fractures combined with spinal coral injuries, for it can attain complete decompression, high recovery rate of the nerve function, high rate of fixation and fusion at oue stage and good spinal stability.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2006年第1期20-23,共4页
Chinese Journal of Trauma
关键词
胸椎
腰椎
骨折
脊柱融合术
前路减压
Thoracic vertebrae
Lumbar vertebrae
Fractures
Spinal fusion
Anterior decompression
