胸腰椎爆裂性骨折的治疗新进展  

New Progress in the Treatment of Thoracolumbar Burst Fractures

作　　者：赵锐[1] 史晓波[1] 刘宏泽[2] 刘玉鹏[1] 张雅玲[3] 赵玉波[2] 

机构地区：[1]包头医学院第二附属医院骨科,内蒙古包头014030 [2]包头市第三医院,内蒙古包头014030 [3]哈尔滨医科大学第一附属医院,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2014年第27期5391-5393,5400,共4页Progress in Modern Biomedicine

摘　　要：胸腰椎爆裂骨折是常见的脊柱损伤性疾病之一,其发病率、致残率较高是由胸腰段脊柱的解剖学特点所决定。国内外有多种脊柱骨折的分类,临床中使用较多的有AO分类及Denis分类,脊柱载荷分享分类现多用于评价患者是否适合于后路手术,而不能应用于评估手术指征。目前国内外胸腰椎爆裂性骨折的治疗尚无统一定式,大多数学者倾向于积极的手术治疗,其中尤以后路手术治疗为主,后路手术多采取短节段椎弓根定内固定加植骨治疗。近些年又出现了经后路270°或360°椎管减压,重建脊柱的三柱稳定性。前路及前后路联合手术都有其各自的适应症。保守治疗多采取卧床休息、体位复位、外固定支具法及功能康复等。本文总结了近年来关于胸腰椎爆裂骨折的最新治疗进展。Thoracolumbar burst fracture is one of the common diseases of spine injury. Its high incidence and disability rates are determined by the anatomic characteristics of its own. There are a variety of spinal fracture classifications in China and abroad, AO and Denis classifications are most common used ones in clinical situation. Spinal load sharing classification is used to evaluate whether the patient is suitable for posterior operation, but not to evaluate the operation indications. Currently, there isn＇t a uniform treatment for thoracolumbar burst fractures at home and abroad. Most scholars tend to take positive operation, especially the posterior surgery. Short-segment pedicle fixation and bone graft treatment are usually adopted in posterior operation. In the recent years, the emergence of posterior 270° or 360° decompression reconstructs the three column spinal stability. Anterior or combination of anterior and posterior operation has its own indications. Bed rest, postural reduction, external fixation brace and functional rehabilitation are commonly used in conservative treatment.. This paper summarizes the latest progress in the treatment of thoracolumbar burst fractures in recent years.

关 键 词：胸腰椎 爆裂性骨折 保守治疗 手术治疗 

分 类 号：R683.2[医药卫生—骨科学]