一期前后路联合手术治疗严重胸腰椎骨折伴脊髓损伤  

One-stage combined anterior and posterior approaches surgery for severe thoracolumbar fractures with spinal cord injuries

作　　者：张翊 王斌 郭东哲 陆建强 ZHANG Yi;WANG Bin;GUO Dong-zhe;LU Jian-qiang(Section Ⅰ,Dept of Orthopaedics,the Marine Police General Hospital of Chinese People′s Armed Police Forces,Jiaxing,Zhejiang 314000,China)

机构地区：[1]中国人民武装警察部队海警总队医院骨一科,浙江嘉兴314000

出　　处：《临床骨科杂志》2021年第3期305-308,共4页Journal of Clinical Orthopaedics

基　　金：浙江省嘉兴市科技局应用性基础研究专项基金(编号:2019AD32047)。

摘　　要：目的探讨一期前后路联合手术治疗严重胸腰椎骨折伴脊髓损伤的疗效。方法采用一期前后路联合手术治疗24例严重胸腰椎骨折伴脊髓损伤患者。记录手术时间、术中出血量、骨融合及Frankel分级情况。结果手术均顺利完成,手术时间180~320(250±11)min,术中出血量700~1800(800±25)ml。患者均获得随访,时间12~18个月。植骨节段均骨性融合,融合时间10~14个月。术后12个月Frankel分级:B级4例中1例未恢复、3例恢复至C级,C级13例中10例恢复至D级、3例恢复至E级,D级7例均恢复至E级。结论一期前后路联合手术治疗严重胸腰椎骨折伴脊髓神经损伤安全有效,能早期重建脊柱稳定性,有助于神经功能的恢复。Objective To investigate the clinical effect of one-stage combined anterior and posterior approaches approaches surgery for treatment of severe thoracolumbar fractures with spinal cord injuries.Methods The 24 cases of severe thoracolumbar fractures with spinal cord injuries were received surgery treatment,all patients were treated with one-stage combined anterior and posterior approaches approaches surgery.Operation time,intraoperative bleeding volume,bone fusion and Frankel classification situation were recorded.Results All the operations were completed successfully,the operation time was 180~320(250±11)min,intraoperative blood loss was 700~1800(800±25)ml.All the patients were followed up for 12~18 months.All of the bone grafting got bony fusion within 10~14 months.Frankel grade in 12 months after operation:in 4 cases of grade B,1 case did not recover,and 3 cases recovered to grade C;10 of 13 cases with grade C recovered to grade D,and 3 cases recovered to Grade E;7 cases of grade D recovered to grade E.Conclusions One-stage combined anterior and posterior approaches surgical treatment for severe thoracolumbar fractures with spinal cord injuries are safe and effective,which can reconstruct the stability of spine early,and promote the recovery of nerve function.

关 键 词：前后路联合内固定 脊髓损伤 胸腰椎骨折 

分 类 号：R683.2[医药卫生—骨科学] R687.32[医药卫生—外科学]