经椎弓根伤椎次全切除减压治疗胸椎爆裂骨折并截瘫  

Subtotal corpectomy through the pedicle for treating the burst fracture of thoracic vertebrae with paralysis

作　　者：丁真奇[1] 庄平[1] 郭志民[1] 

机构地区：[1]解放军第175医院(厦门大学附属东南医院)骨科,全军创伤骨科中心,福建漳州363000

出　　处：《中国矫形外科杂志》2009年第16期1210-1213,共4页Orthopedic Journal of China

摘　　要：[目的]探讨经椎弓根行伤椎次全切除减压,椎体间钛笼支撑植骨、椎弓根钉系统内固定治疗胸椎爆裂骨折并截瘫的临床疗效及优越性。[方法]23例胸椎爆裂骨折并截瘫患者,全部采用经椎弓根伤椎次全切除、椎管减压,钛笼加自体松质骨粒椎体间支撑,椎弓根钉系统内固定治疗。[结果]随访8个月～2年,均无切口感染、血气胸、肺部感染等并发症,椎间植骨均融合好,内固定无松动、脱落、断裂等,Cobb's角丢失平均为3.5°。Frankel分级:术前A级6例术后未见改善;B级5例恢复至C级3例、D级1例、E级1例;C级7例恢复至D级3例、E级4例;D级5例恢复至E级。[结论]经椎弓根伤椎次全切除减压,椎体间钛笼支撑植骨,椎弓根钉系统内固定创伤相对较小,临床疗效满意。[ Objective] To investigate the clinical curative effect and superiority of subtotal corpectomy through the pedicle, titanium fete support and pedicle screws system fixation in the treatment of burst fracture of thoracic vertebrae with paralysis. [ Method ] Twenty-three patients who suffered from the burst fracture of thoracic vertebrae with paralysis were treated with subtotal corpectomy through pedicle, titanium rete supporting hone autograft and pedicle screws system fixation. [ Result ] The patients were followed up for 8 months to 2 years. All had their bone grafts fused, and no incision infection, pneumothorax, hemothorax, pulmonary infection, internal fixation loosening or breakage occurred. The mean loss of Cobb＇s angle was 3.5°. According to Frankel grading,6 of grade A had no obvious recovery. In 5 of grade B ,3 improved to C,I to D,and the last one to E. In 7 of grade C,3 improved to D,4 to E. Five cases of grade D improved to E. [ Conclusion] There had relatively less operation wound and good clinical curative effect with subtotal corpectomy through pedicle, titanium rete supporting bone autograft and pedicle screws system fixation.

关 键 词：胸椎 脊柱骨折/外科学 截瘫 后路减压 

分 类 号：R687.3[医药卫生—骨科学]