经后路三柱重建治疗累及后柱的不稳定性胸腰椎爆裂骨折  

Three column reconstruction via posterior approach for the treatment of unstable thoracolumbar fracture accompa- nied by posterior column injury

作　　者：郭学德[1] 梁西俊[1] 刘向阳[1] 宋财[1] 

机构地区：[1]亳州市人民医院骨科,安徽亳州236800

出　　处：《中国骨伤》2014年第1期64-66,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨经后路三柱重建治疗累及后柱的不稳定性胸腰椎爆裂骨折的疗效。方法：2008年12月至2010年5月，对21例累及后柱损伤的不稳定性胸腰椎爆裂骨折患者，经后路伤椎次全切植骨支撑内固定，并行后外侧植骨。21例中，男13例，女8例；年龄23～54岁，平均35.5岁。骨折椎体：T11 1例，T12 4例，L1 8例，L2 5例，L3 3例。术前Cobb角（25.34±3.42）°。观察手术时间、术中出血量、Cobb角和植骨融合情况。结果：所有患者获随访，时间24～27个月，平均25.6个月。手术时间135～275 min，平均185 min.术中出血量700～1 650 ml，平均870 ml.术后所有患者椎管减压充分。Cobb角术后（4.01±2.03）°，末次随访（4.34±2.38）°。21例均获得植骨融合。结论：对于累及后柱的不稳定性胸腰椎爆裂骨折，经后路三柱重建术兼具前、后联合入路的手术优势，能够取得较好的临床效果。Objective： To investigate clinical effects of three-column reconstruction via single posterior approach for the treatment of unstable thoracolumbar fractures accompanied by posterior column injury. Methods： From December 2008 to May 2010,three-column reconstruction via posterior approach was implemented to 21 patients with unstable thoracolumbar fractures accompanied by posterior column injuries. There were 13 males and 8 females,ranging in age from 23 to 54 years old（averaged,35.5 years old）. Injured vertebrae：1 patient had injury in T11,4 patients had injuries in T12,8 patients had injuries in L1,5 patients had injuries in L2,3 patients had injuries in L3. The Cobb angle was（25.34±3.42）°. The operation time,blood loss during operation,Cobb angle and the bony fusion were observed. Results： Twenty-one patients were followed up,and the duration ranged from 24 to 27 years old,with an average of 25.6 months. The operation time ranged from 135 to 275 min,with a mean of 185 min. The blood loss during operation ranged from 700 to 1 650 ml（averaged,870 ml）. All the patients had complete decompression. Postoperative Cobb angle was（4.01±2.03）°,and（4.34±2.38）° at the latest follow-up. All the patients got bony fusion. Conclusion： To the patients with unstable thoracolumbar fractures accompanied by posterior column injuries,three-column reconstruction via single posterior approach has both anterior approach and posterior approach advantages,which can obtain excellent clinical outcomes.

关 键 词：脊柱骨折 内固定器 脊柱融合术 

分 类 号：R683.2[医药卫生—骨科学]