摘要
目的探讨应用微创小切口进行胸腰椎前柱重建的手术方法及优缺点。方法回顾性分析2005年1月～2006年1月采用微创小切口进行胸腰椎重建的15例患者，并与15例同期行传统前路重建手术的患者进行比较。两组中各有胸腰椎骨折10例，脊柱肿瘤2例，脊柱结核3例，均有不同程度的脊髓损伤。微创小切口组患者经小切口入路进行前路减压或病灶清除、椎间融合、前路钢板内固定，对照组按照传统前路手术入路进行重建。比较两组的出血量、手术时间和神经功能恢复情况。结果30例患者术后获6～16个月（平均10．3个月）随访。微创小切口组出血量明显小于对照组，但手术时间明显长于对照组，两组神经功能恢复接近。微创小切口组未出现与手术入路有关的并发症。结论借助特殊拉钩系统，应用微创小切口进行胸腰椎前柱重建手术操作简单、安全，可以较小的创伤获得与常规手术相同的疗效，且并发症轻微。
Objective To evaluate the minimally invasive approach in the reconstruction of the anterior column of the thoracic and lumbar spines. Methods A retrospective analysis was done for the 15 patients whose anterior columns of the thoracic and lumbar spines had been reconstructed with minimally invasive incision in comparison of another 15 cases treated during the same period with conventional surgery. In each group, there were 10 cases of thoracolumbar vertebral fractures, 2 cases of spinal tumor and 3 cases of spinal tuberculosis. Spinal cord injuries of different degrees were found in all the patients. In the minimally invasive group, the patients were managed with anterior decompression or focal debridement, interbody fusion and internal fixation, while those in the control were treated with conventional anterior reconstruction. The operation time, amount of bleeding and improvement of neural function were compared between the 2 groups. Results Patients were followed up from 6 to 16 months postoperatively （average, 10. 3 months）. In the minimally invasive group, bleeding was significant less and operation time longer. There was no significant difference in the neural function recovery between the 2 groups. No complication occurred in relation to the anterior approach of minimally invasion. Conclusions The minimally invasive reconstruction of the anterior column of the thoracic and lumbar spines is safe and easy to perform, though it requires specially designed retractors. This technique is less traumatic but can achieve as good therapeutic result as the routine method.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第7期642-645,共4页
Chinese Journal of Orthopaedic Trauma
关键词
脊柱骨折
脊柱疾病
骨折固定术
内
钢板
Spine fractures
Spinal diseases
Fracture fixation, internal
Plates
