胸腰椎爆裂骨折椎管狭窄程度与神经损伤的关系及术式选择的临床研究  

THE RALATION BETWEEN DEGREE OF SPINAL CANAL STENOSIS AND NURVAL DAMAGE IN THORACOLUMBAR DISSILIENT FRACTURE AND THE CHOICE OF OPERATIVE WAYS: A CLINICAL STUDY

作　　者：凌义龙[1] 张居适[1] 李志龙[1] 方国华[1] 张胜军[1] 陈栋[1] 魏平洋[1] 周怡[1] 

机构地区：[1]浙江省绍兴市中医院浙江省绍兴市脊柱关节病研究所,312000

出　　处：《中医正骨》2007年第3期9-10,共2页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：为探讨胸腰椎爆裂骨折椎管狭窄情况与神经损伤的关系及手术方式的选择。对80例手术治疗的胸椎爆裂骨折患者进行多指标的回顾性总结分析,参照Wolter方法,对80例患者术前椎管面积减少率进行测算,结果80例中Ⅰ级者14例,Ⅱ级者32例,Ⅲ级者34例。分别对采用前路(35例)及后路(45例)行椎管减压骨折复位内固定术的治疗效果进行Frankel分级,10例A级患者中3例恢复到B级,7例神经功能无恢复;13例B级患者中4例恢复到C级,4例恢复到D级,2例恢复到E级;17例C级患者中5例恢复到D级,9例恢复到E级;21例D级患者中18例恢复到E级。统计结果表明,手术前后椎管面积减少率与Frankel评分相关性有显著统计学意义(P<0.01)。对T11、T12爆裂性骨折选择前路手术脊髓功能恢复情况明显优于后路手术(P<0.05),腰椎爆裂性骨折行前路手术和后路手术之间对脊髓功能恢复情况无相关性统计学意义(P>0.05)。In order to investigate the relation between degree of spinal canal stenosis with nurval damage in thoracolumbar dissilient fracture (TDF)and the choice of operative ways , 80 cases of TDF treated by operation were reviewed and divided into 3 classes including 14 cases inⅠ,32 cases in Ⅱ,34 cases in Ⅲ according Wolter’ method and decreased area of vertebral canal. The clinical effect of 35 cases by anterior operative approach and 45 cases by posterior approach were evaluated by Frankel’ way. The results showed that 3 cases were return to Class B and the reminder had no change in 10 cases of Class A; 4 cases were return to Class C, 4 Cases to Class D, 2 cases to Class E in 13 cases of Class B; 5 cases were return to Class D, 9 cases to Class E in 17 cases of Class C; 18 cases were return to Class E in 21 cases of Class D; there had a significant difference between the decreased area of vertebral canal with Frankel’s scored(P<0.01); the anterior operative approach had an advantage for functional recovery of spinal cord compared the posterior(P<0.05) while there were no relation between the two operative approaches(P>0.05).

关 键 词：胸腰椎爆裂骨折/治疗 术式选择 椎管狭窄程度与神经损伤的关系 临床研究 

分 类 号：R687.3[医药卫生—骨科学]