胸椎骨折  

Thoracic Spine fractures

作　　者：戴力扬[1] 茆振华[1] 沈建中[1] 周之德[1] 姜其为[1] 胡清潭[1] 

机构地区：[1]上海第二医科大学附属新华医院骨科,上海市控江路1665号200092

出　　处：《中国矫形外科杂志》2002年第5期424-426,共3页Orthopedic Journal of China

摘　　要：目的 :探讨胸椎骨折的损伤特点及治疗。方法 :对 1组 77例胸椎骨折病例作回顾性分析 ,其中压缩骨折 3 7例 ,骨折脱位 3 4例 ,爆裂骨折 3例 ,爆裂脱位 3例。完全性瘫痪 2 6例 ,不完全性瘫痪 14例 ,无神经损害 3 7例。非手术治疗 5 3例 ,手术治疗 2 4例。结果 :随访 2～ 15年。 2 6例完全性瘫痪病例无一改善 ,3 7例无神经损害患者无病情加重 ,但其中 13例仍有局部疼痛 ,14例不完全性瘫痪病例中有 2例恢复正常 ,7例有改善 ,5例无变化。结论 :由于胸椎在解剖学及生物力学方面的特殊性 ,以往主要用于胸腰椎骨折的分类方法显然不适于胸椎骨折。对于不稳定骨折应行融合及内固定手术 。Objective:To emphasize the characteristics and treatment of thoracic fractures.Methods:Seventy seven patients with thoracic fractures were retrospectively reviewed.Of these,there were 37 compressed fractures,34 fracture dislocations,three burst fracture and three burst dislocations.Twenty six patients had a complete lesion of the spinal cord,14 sustained a neurologically incomplete injury,and 37 were neurologically intact.Fifty three patients were treated nonoperatively and 24 underwent surgery.Results:All patients were followed up for 2～15 years.None of the 26 patients with a complete paralitic lesion recovere any significant function.Of 37 neurologically intact patients,13 had local pain although all of them remained normal function.Two of 14 patients with incomplete paraplegia returned to normal,seven recovered some funcion and five did not recover.Conclusions:Because of the unique anatomy and biomechanics of the thoracic spine,the classification commonly applied to thoracolumbar fractures is not suitable for thoracic fractures.Fusion and instrumentation is indicated when the fractures are unstable,while patients with incomplete lesion of the spinal cord may be the candidates for supplemented decompression.

关 键 词：脊柱损伤 脊髓损伤 治疗 胸椎骨折 

分 类 号：R683.2[医药卫生—骨科学]