经椎间孔椎体间植骨治疗胸腰椎C型旋转骨折脱位  

Transforaminal lumbar interbody fusion for Type C thoracolumbar complete rotational fracture and dislocation

作　　者：张正丰[1] 周跃[1] 王洪岗[1] 王建[1] 李长青[1] 郑文杰[1] 初同伟[1] 潘勇[1] 

机构地区：[1]第三军医大学新桥医院骨科,重庆400037

出　　处：《脊柱外科杂志》2013年第5期264-268,共5页Journal of Spinal Surgery

摘　　要：目的探讨后路经椎间孔椎体间融合治疗胸腰椎C型旋转骨折脱位的可行性及疗效。方法 2009年3月～2010年8月收治胸腰椎AO分型C型旋转骨折脱位患者10例,均为青年男性,伤椎累及T10～L3。AO分类C1型7例,C3型3例,神经功能按美国脊髓损伤学会(American Spinal Injury Association,ASIA)分级全部为A级。均行后路椎弓根螺钉内固定结合经椎间孔椎体间植骨融合手术治疗,术后随访神经功能恢复和植骨愈合。结果 10例患者手术时间平均130 min,术中出血平均520 mL。术后X线片显示脊柱复位良好,植骨位置良好。随访12个月椎间植骨均获得骨性融合,4例ASIA分级A级恢复到B级,6例无恢复。结论后路切开复位减压椎弓根螺钉内固定结合经椎间孔椎体间融合能从单一入路能同时完成胸腰椎C型旋转骨折脱位的减压、复位、固定和融合的治疗。Objective To explore feasibility and therapeutic： effect of posterior pediele screw fixation combined with transforanfi nal lumbar interbody fusion（TLIF） for traumatic Type C thoracolumbar complete rotational fracture and dislocation Methods From March 2009 to August 2010, 10 patients with complete rotational fracture and dislocation of throracolumar vertebra types C （classi- fied by AO） underwent posterior pedicle screw fxation and . Cases are all males, 7 cases of C1 and 3 cases of C3. The involved levels were Ti0-L3. The neurological function were Grade A classified by American Spinal Injury Assoeiation（ASIA） classi- fication. Postoperative neurologicM status, coneetion and loss of dislocation, location and union of bone grafting were reviewed. Results All operation were sueeessfill. Operative time was 120-150 nfin （mean 130 min）, blood loss was 300-800 mL （mean 520 mL）. The follow- up time was 12 months. The spine curvature was recovered to normal and the intervertibral bone grafting was well fixed. All 12 months follow-up patients obtained bony fusion. Four patients with ASIA Grades A improved to B, 6 had no improvement. Conclusion Posterior pedicle screw fixation combined with transforaminM lumbar interbody fusion for traumatic Type C tboracolumbar complete rotational fracture and dislocation can accomplish deeompression, reduction, fusion and fixation from one incision.

关 键 词：胸椎 腰椎 脊柱骨折 骨移植 脊柱融合术 

分 类 号：R683.2[医药卫生—骨科学]