Ⅰ期后入路半椎板切除减压治疗胸腰椎爆裂骨折伴脊髓圆锥/马尾神经损伤的疗效观察  

Outcome of one stage semi-laminectomy decompression and posterior instrumentation in treatment of thoracolumbar burst fractures with medullary cone injury or cauda equina nerve lesion syndrome

作　　者：陈延岭 蔡沅锜 张建平[1] 蔡芝军 齐欣[1] 汤逊[1] CHEN Yan-ling;CAI Yuan-qi;ZHANG Jian-ping(The No.920 Hospital of Joint Logistics Support Force of PLA,Chendu,Sichuan 610000)

机构地区：[1]中国人民解放军联勤保障部队第920医院,云南昆明650032

出　　处：《中国伤残医学》2019年第2期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:评价Ⅰ期后入路半椎板切除减压治疗胸腰椎爆裂骨折伴脊髓圆锥/马尾神经损伤的临床效果.方法:选取自2010年6月-2015年7月,我院采用Ⅰ期后入路半椎板切除减压治疗胸腰椎爆裂骨折伴脊髓圆锥/马尾神经损伤的患者31例,术后随访复查胸腰椎X线、CT等检查,比较患者手术前、后Cobb's角、VAS评分和骨块占椎管容积的变化.结果:术后31例患者均获得随访,随访时间平均11.3个月.手术前、后Cobb's角、VAS评分明显改善,差异具有统计学意义;术前CT检查椎管内骨块占椎管容积平均为45%-70%,术后椎管内骨块占椎管容积平均为0%-15%.31例脊髓神经损伤患者恢复率为83.87%.结论:采用Ⅰ期后入路半椎板切除减压治疗胸腰椎爆裂骨折伴脊髓圆锥/马尾神经损伤具有良好的疗效,值得临床应用.Objective:To evaluate the outcome of thoracolumbar burst fracture patients with Medullary cone injury or cauda equina nerve lesion syndrome who underwent one stage semi-laminectomy decompression and posterior instrumentation.Methods:From June 2010 to July 2015,31 cases with Thoracolumbar burst fracture complicated with nerve injury who underwent one stage semi-laminectomy decompression and posterior instrumentation in our hospital were included in this study.The X-ray and CT examinations of patients were performed follow-up.The changes of Cobb's angle,VAS score and the volume of vertebral canal were compared between the patients before and after operation.Results:All patients were followed up for an average time of 11.3 months.Pre-and postoperative the Cobb's Angle and the VAS were improved obviously,the difference was statistically significant.The volume Spinal canal were occupied by fracture fragments about the average of 45%-70% at the.patients in preoperative with the CT scan.The volume Spinal canal were occupied by fracture fragments about the average of 0%-15% at the patients in postoperative with the CT scan.Conclusion:One stage semi-laminectomy decompression and posterior instrumentation had a good treatment in the thoracolumbar burst fractures patients with Medullary cone injury or canda equina nerve lesion syndrome.It should be worthy of clinical application.

关 键 词：胸腰椎爆裂骨折 脊髓圆锥损伤 马尾神经损伤 

分 类 号：R683.1[医药卫生—骨科学]