胸腰段爆裂骨折脊柱前路减压手术的临床效果评价  

Evaluation Of The Clinical Outcome Of Anterior Decompression In thoracic waist spinal column Burst Fracture

作　　者：刘世桢[1] 刘先银[1] 郭建恩[1] 吴容[1] 温志勋[1] 

机构地区：[1]东莞市人民医院,广东东莞523008

出　　处：《基层医学论坛》2006年第11期964-965,F0003,共3页The Medical Forum

摘　　要：目的观察脊柱前路减压、植骨内固定术治疗胸、腰椎爆裂骨折伴脊髓损伤的治疗效果。方法自1999年10月￣2005年3月间,应用该方法治疗28例胸腰椎爆裂骨折伴全瘫及不全瘫病例。男22例,女6例,年龄21岁￣55岁。CT检查本组病例均存在外伤性椎管狭窄。24例病人采用前路脊髓减压植骨Profile及Z-plate钢板内固定术;4例应用前路脊髓减压植骨Mossmaimi钉棒系统。选用国际脊髓损伤神经功能评定法来评价病人术前、术后的神经功能恢复情况及术前、术后CT检查对比了解脊髓减压、植骨块位置及植骨融合情况。结果28例中22例病人术后脊髓神经功能感觉、运动评分明显恢复(P<0.05),椎体高度恢复且稳定。2例出现脑脊液漏,8天￣14天伤口自行愈合。结论胸腰椎爆裂骨折伴脊髓损伤及椎管狭窄病例采用脊髓前路减压、植骨固定方法,可直接去除脊髓前方的骨性压迫,符合损伤病理。植骨固定不仅恢复椎体高度,而且可获得脊柱的即刻稳定,为脊髓功能恢复创造良好的条件。因此,本组病例脊髓神经功能有明显恢复。Objective To evaluate the outcome of anterior decompression, bone graft and internal fixation in treating thoracic wais burst fracture and spinal injury. Methods From Oct 1999 to Mar 2005,We treated 28 cases of the thorocolumbar burst fracture with Anterior Decompression . 22 cases was Maleand 6 cases Female. The patient ranged from 21-55 years old. All of theses cases existed the traumatic spinal stenosis certified with CT scan. Anterior decompression, bone graft and Profile or Z-plate internal fixation was used in 24 cases. Anterior decolnpression, bone graft and Mosslnaimi Screw-Rod system was used in 4 cases. We evaluated the recovery of nerve function with the International Evaluation system of nerve filnction in Spinal cord Injury. We contrasted the decompression, position of grafted bone and fllsion with CT scan in pre- and post-operation. Results The spinal cord thnction recovered significantly （P〈0.05） in 22 cases. The height of vertebral body was normal and no change. Leakage of cerebrospinal fluid occurred in 2 cases, arid cured in 8-14 days. Conclusion To treat the thoracic waist spinal column Burst Fracture combined with the spinal cord injury and stenosis, the method of anterior decompression and bone graft could remove the anterior compressioll directly. It accorded with traumatic pathology. Bone graft can not only recover the height of vertebral body but also instant stablizatin of spine. And can create a better condition for recovery of spinal cord function.

关 键 词：爆裂骨折 脊髓损伤 减压Profile Z-PLATE钢板 

分 类 号：R687.3[医药卫生—骨科学]