摘要
目的 针对前路减压Ｋａｎｅｄａ装置内固定方法治疗胸腰段脊柱骨折手术创伤大、失血多。操作复杂和Ｋａｎｅｄａ装置安装不方便等问题进行技术改进。方法 将Ｋａｎｅｄａ装置的椎体螺钉与螺棒的穿套式结合方式改为卡锁式结合，采用经第１２肋胸膜外－腹膜后入路显露，对手术操作程序和伤椎切除范围进行了改进。结果 ３８例胸腰段脊柱骨折患者手术均获成功。技术改进后手术中平均失血量８８０ ｍｌ，手术操作时间平均 １４０分钟，手术切口长度 １８～２０ ｃｍ。随访 ９～４０个月，平均 ２４． ３个月。术后无截瘫加重，脊柱序列正常，椎管扩大，无假关节形成和内固定失败，神经功能获１级以上恢复者达９７％。结论本技术改进具有切口短、手术创伤较轻、失血少、降低手术操作难度的优点，改型后的Ｋａｎｅｄａ装置安装简便，固定可靠。
<Abrstract>Objective To describe the results and advantages of modified Kaneda device and the improved procedure for the treatment of thoraco-lumbar fractures. Methods The insertion lasso connection of Kaneda device was changed into a block connection; an extrapleural and retroperitoneal approach with resec tion of the left twelfth rib were used; thus improved the limit of the extent of vertebral body resection. Results All of the 38 cases had successful surgery; the average operation time was 140 minutes, the average amount of blood loss was 880 ml and the length of incision was 18 - 20 cm. After an average of 24. 3 months fol lowed-up, none of the patients had neurological deterioration; the spinal canals were enlarged, the spine re covered normal curvature and the fusional rate was 100%. No failure of implant happened. Neurological function was improved by at least one grade in 97%. Conclusion The technical improvements have the advantage of less injury, less blood loss and a short incision. The modified Kaneda device fixation not only provided stability but also convenient installation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1999年第11期645-647,共3页
Chinese Journal of Orthopaedics
关键词
腰椎骨折
减压
内固定器
胸椎骨折
重建
Thoracic vertebrae Lumbar vertebrae Fractures Decompression Internal fixators
