微创脊柱内固定治疗胸腰段Chance骨折  

Minimally invasive spinal surgery for thoracolumbar chance-type fracture

作　　者：张向阳[1] 梁朝革[1] 唐献忠[1] 陈豪杰[1] 于荣华[1] 王弈[1] 李一凡[1] 

机构地区：[1]上海交通大学医学院附属同仁医院骨科,上海200336

出　　处：《颈腰痛杂志》2015年第3期201-203,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨微创脊柱手术治疗胸腰段Chance骨折的方法。方法回顾分析2010-10-2014-03经后路微创脊柱内固定系统治疗胸腰段Chance骨折25例,按照Denis屈曲过伸分型Ⅰ型14例,Ⅱ型8例,Ⅲ型2例,Ⅳ型1例,术前完善CT和MRI明确诊断,手术采用UPASSⅡ脊柱微创系统内固定,术后定期随访,随访指标以患者伤椎前缘高度恢复程度为主。结果本组25例均获得随访,4-6周内骨折愈合良好,可护腰保护下功能锻炼。伤椎前缘高度由术前(70.4±14.3)%恢复至术后(95.8±4.1)%。临床疗效根据Macnab评分优良率80%。结论 Chance骨折为不稳定骨折,应行手术治疗;微创脊柱内固定系统适用于不需进行椎管探查的chance骨折治疗。Objective To discuss the method of minimally invasive spinal surgery for thoracolumbar chance-type fracture. Methods Review 25 cases with chance fracture through rear minimally invasive internal-fixed spinal surgery between 2010 October and 2014 March at regular follow-up visit. According to the Denis clissification,I type in 14 cases,II type in 8 cases,III type in 2 cases,IV type in 1 cases. All the cases were diagnosed by means of Computed Tomography and Magnetic Resonance Imaging. UPASS II minimally invasive spinal internal fixation system were adopted in all operations,the major target of the routine follow-up examination is recovering vertebrae height. Results The 25 cases injured thoracolumbar spine grew well,and even they can walk gradually with the help of brace 4-6 weeks post-operatively. Conclusion The complications of chance-type fracture should be paid more attention;Chance-type fracture is unstable,surgical treatmen is the optimal method for it regardless of neurological symptoms;for the cases with unconspicuous intraspinal placeholder or unconspicuous neurologic symptoms,minimal invasive spinal inter-fixed system is a better therapeutic method,little trauma early recovery result is good.

关 键 词：微创 脊柱内固定 CHANCE骨折 

分 类 号：R683.2[医药卫生—骨科学]