摘要
目的对胸腰段脊柱脊髓、马尾神经损伤患者的外科治疗及几种内固定方法的疗效进行探讨.方法对166例患者的治疗进行回顾分析.该组患者中椎体爆裂性骨折37例,椎体压缩骨折超二分之一109例,椎体骨折脱位14例,多节段或跳跃骨折6例.脊髓损伤按Frankel分级,A级59例、B级46例、C级42例、D级19例.治疗采用后路减压复位122例,前路减压复位、髂骨植骨融合44例.结果术后有123例获3～18个月随访,随防患者中除4例RF钉断裂,5例Harrington上钩脱落,6例棍断裂,其余患者内固定稳固.脊髓、马尾神经恢复:除35例仍为A级外,余脊髓神经功能恢复1～3个级别.结论各种不同内固定可保持或增强脊柱的稳定.胸腰段脊柱脊髓损伤的外科治疗应根据骨折类型、脊髓及马尾神经损伤程度选择手术入路及内固定材料.
Objective To evaluatethetherapeuticeffectof severalinternalfixationmethodsin thesurgicaltreatmentof thoracolumbarspineand spinalcordinjury(SSI-TL).Methods In the166SSI-TLcasesincludedin thisretrospective analysis,37hadvertebralbodyburstfracture,109hadvertebralbodycompressionfracture(withcompressionto a degreeover50%),14hadvertebralbodyfractureanddislocationand6hadmultilevelvertebralfracturesor jumpingfracture.In viewof thespinalcordinjury59belongedto FrankelgradeA,46gradeB,42gradeC and19gradeD.Posteriordecompression,reductionandinternalfixationwereperformedin122patientsandtheother44underwentanteriordecompression,reduction andiliumbonegrafting.Results Follow-upstudyfor3to18monthwas conductedin123cases,in whichRF screws crackingoccurredin4cases,Harringtonupperhookdislocationin5casesandHarringtonrodcrackingin6,whiletherest caseswerefreeof thesesincidents.In termsof thefunctionrecoveryof thespinalcord,88casesshowedimprovementof the spinalcordandcaudaequinaof1to3Frankelgrades,leavingonly35lingeringin gradeA.Conclusion Decompression shouldbe performedat earlystagesof SSI-TL,andemploymentof variousinternalfixationinstrumenthelpsmaintainand enhancespinalstability,preventingsecondarylesionof thespinalcordandpromotingthefunctionrecoveryof theinjured spinalcord.
出处
《第一军医大学学报》
CSCD
北大核心
2002年第1期82-83,共2页
Journal of First Military Medical University
基金
广东省火炬计划项目(C11202)
全军"十五"指令性课题
关键词
胸腰椎骨折
减压
内固定
thoracolumbarfracture
decompression
internalfixation
