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[1]周成洪,龍亨國,徐建廣,等.后路經(jīng)椎弓根切除椎體三柱重建技術(shù) 在胸腰椎爆裂性骨折的臨床應(yīng)用和療效分析[J].中醫(yī)正骨,2011,23(02):11-13.
　Zhou Cheng-hong*,Long Heng-guo,Xu Jian-guang,et al.After Resection of the Vertebral PedicleSpent Three Pillars Reconstruction Technique in Thoracolumbar Burst Fracture of Clinical Application and Effect Analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(02):11-13.
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后路經(jīng)椎弓根切除椎體三柱重建技術(shù) 在胸腰椎爆裂性骨折的臨床應(yīng)用和療效分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期數(shù):
2011年02期
頁碼:
11-13
欄目:
臨床研究
出版日期:
2011-02-25

文章信息/Info

Title:
After Resection of the Vertebral PedicleSpent Three Pillars Reconstruction Technique in Thoracolumbar Burst Fracture of Clinical Application and Effect Analysis
作者:
周成洪1; 龍亨國1; 徐建廣2; 沈萬祥1; 連小峰2; 劉玖行1
1.浙江省舟山市中醫(yī)骨傷聯(lián)合醫(yī)院,浙江 舟山 316000;
2.上海交通大學(xué)第六人民醫(yī)院,上海 200233
Author(s):
Zhou Cheng-hong*; Long Heng-guo; Xu Jian-guang; et al.*
Zhoushan City Chinese Traumatology Hospital,Zhoushan 316000,Zhejiang,China
關(guān)鍵詞:
胸椎 腰椎 爆裂性骨折 椎體切除 重建
Keywords:
Thoracic vertebrae;  Lumbai vertebrae;  burst fraxturi;  Vertebrectomy;  Reconstruxtion
摘要:
目的:探索創(chuàng)傷小、脊髓減壓徹底、術(shù)后脊柱三柱即刻穩(wěn)定、患者可早期活動(dòng)的治療胸腰椎爆裂性骨折的手術(shù)方案。方法:21例胸腰椎爆裂骨折患者,經(jīng)后路單側(cè)行椎體次全切除、脊髓環(huán)形減壓、鈦網(wǎng)支撐植骨重建前中柱及椎弓根釘后柱內(nèi)固定。采用美國脊柱損傷學(xué)會(huì)(ASIA)分級(jí)進(jìn)行神經(jīng)功能評(píng)估,通過X線及CT片評(píng)估骨折復(fù)位、減壓及骨融合情況。結(jié)果:手術(shù)均順利完成,平均手術(shù)時(shí)間3.1 h; 平均出血量1180 mL。術(shù)后發(fā)生腦脊液漏2例,無其他嚴(yán)重并發(fā)癥發(fā)生。隨訪患者植骨融合,內(nèi)固定無松動(dòng)、斷裂,椎體高度、曲度和椎管容積無明顯丟失。除A級(jí)患者外,其他各級(jí)患者神經(jīng)功能均有不同程度的恢復(fù)。結(jié)論:后路單側(cè)椎體減壓重建脊柱三柱穩(wěn)定性手術(shù)具有創(chuàng)傷小、脊髓減壓徹底、脊柱前中后柱即刻穩(wěn)定等特點(diǎn),可有效恢復(fù)椎體高度、脊柱的生理曲度、椎管容積和脊柱即刻穩(wěn)定性,是治療胸腰椎爆裂骨折的理想手術(shù)方式。
Abstract:
Objective:To explore an operation method with less injury,thorough spinal cord decompression,prompt post-operative three-column stability of spine and early movement for patients with thoracolumbar burst fractures in high altitude.Methods:Totally 21 patients with thoracolumbar burst fractures accepted posterior unilateral subtotal corpectomy,annular decompression of spinal cord,titanium mesh bone graft for reconstruction of anterior and middle column combined with pedicle instruments fixation.Spinal cord injury was evaluated with ASIA grade criterion.Reduction,decompression and fusion of fractures were evaluated through X-ray and computer tomography.Results:All operations were completed successfully.The mean operation time was 3.1 hours and the mean blood loss was 1180ml.Cerebrospinal fluid leakage occurred in 2 patients.No other severe complications were observed.Bone graft fusion was observed in follow-up patients.No looseness and rupture of internal fixation,no obvious loss of vertebral height,spinal radian and vertebral canal volume were observed.Nervous function improved in different degree in all patients except those who had the nervous function of grade A.Conclusion:The operation of posterior unilateral subtotal corpectomy and reconstruction of spinal three-column stability has the advantages of less injury,thorough pinal cord decompression,prompt post-operative three-column stability of spine,and can effectively restore vertebral height,vertebral canal volume,physiological radian and prompt stability of spine.It is an ideal operation method for the treatment of thoracolumbar burst fractures.

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更新日期/Last Update: 2011-02-25